Hemochromatosis classification: update and recommendations by the BIOIRON Society

Hemochromatosis (HC) is a genetically heterogeneous disorder in which uncontrolled intestinal iron absorption may lead to progressive iron overload (IO) responsible for disabling and life-threatening complications such as arthritis, diabetes, heart failure, hepatic cirrhosis, and hepatocellular carc...

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Hauptverfasser: Girelli, Domenico (VerfasserIn) , Busti, Fabiana (VerfasserIn) , Brissot, Pierre (VerfasserIn) , Cabantchik, Ioav (VerfasserIn) , Muckenthaler, Martina (VerfasserIn) , Porto, Graça (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: May 19, 2022
In: Blood
Year: 2022, Jahrgang: 139, Heft: 20, Pages: 3018-3029
ISSN:1528-0020
DOI:10.1182/blood.2021011338
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1182/blood.2021011338
Volltext
Verfasserangaben:Domenico Girelli, Fabiana Busti, Pierre Brissot, Ioav Cabantchik, Martina U. Muckenthaler, Graça Porto, on behalf of the Nomenclature Committee of the International Society for the Study of Iron in Biology and Medicine (BIOIRON Society)

MARC

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520 |a Hemochromatosis (HC) is a genetically heterogeneous disorder in which uncontrolled intestinal iron absorption may lead to progressive iron overload (IO) responsible for disabling and life-threatening complications such as arthritis, diabetes, heart failure, hepatic cirrhosis, and hepatocellular carcinoma. The recent advances in the knowledge of pathophysiology and molecular basis of iron metabolism have highlighted that HC is caused by mutations in at least 5 genes, resulting in insufficient hepcidin production or, rarely, resistance to hepcidin action. This has led to an HC classification based on different molecular subtypes, mainly reflecting successive gene discovery. This scheme was difficult to adopt in clinical practice and therefore needs revision. Here we present recommendations for unambiguous HC classification developed by a working group of the International Society for the Study of Iron in Biology and Medicine (BIOIRON Society), including both clinicians and basic scientists during a meeting in Heidelberg, Germany. We propose to deemphasize the use of the molecular subtype criteria in favor of a classification addressing both clinical issues and molecular complexity. Ferroportin disease (former type 4a) has been excluded because of its distinct phenotype. The novel classification aims to be of practical help whenever a detailed molecular characterization of HC is not readily available. 
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