P10 Liver iron concentration determined by magnetic resonance imaging is superior to serum ferritin in haemochromatosis
| Autor: | Edmund M. Godfrey, William J.H. Griffiths, Ilse Paterson, Meha Bhuva, David J. Bowden |
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| Rok vydání: | 2020 |
| Předmět: |
Liver Iron Concentration
medicine.medical_specialty biology medicine.diagnostic_test Transferrin saturation business.industry Standard treatment Magnetic resonance imaging Compound heterozygosity Positive correlation Gastroenterology Ferritin Internal medicine biology.protein Medicine business Serum ferritin |
| Zdroj: | Abstracts. |
| DOI: | 10.1136/gutjnl-2020-basl.21 |
| Popis: | Background Venesection is the standard treatment for hereditary haemochromatosis (HH) preventing morbidity and mortality, but therapeutic venesection may not be clinically beneficial in all patients. Furthermore, serum ferritin may not accurately reflect the true extent of iron overload. To inform practice we correlated magnetic resonance (MR) iron quantification data in a cohort investigated for HH. Methods A cross-sectional study of 93 hyperferritinaemic subjects without known liver or haematological disease was undertaken. All subjects underwent HFE genotyping and MR imaging with hepatic iron quantification. Serum ferritin and transferrin saturation values were time-matched with MR liver iron concentration (LIC). For those patients undergoing venesection, volume of blood removed was calculated as a measure of iron overload. Results The cohort comprised 45 C282Y homozygotes, 23 compound heterozygotes (C282Y/H63D) and 25 who were either C282Y heterozygotes or wild-type for HFE. Of 45 C282Y homozygotes (20 females, 25 males, mean age 60), serum ferritin ranged 184–4523 mcg/l (mean 1027 mcg/l), transferrin saturation 43–100% (mean 81%), and LIC 1.27–9.97 mg/g (mean 5.06 mg/g). Removing the two homozygotes with ferritin >3000 mcg/l, there was a moderately positive correlation between ferritin and LIC in homozygotes (r=0.48). Of 23 compound heterozygotes (5 females, 18 males, mean age 55), serum ferritin ranged 418–3016 mcg/l (mean 1033 mcg/l), transferrin saturation 29%-100% (mean 51%) and LIC 1.36–4.58 mg/g (mean 2.43 mg/g). Serum ferritin of >1000 mcg/l had 92% sensitivity and 50% specificity for the detection of significant iron overload (LIC >2.5 mg/g). In the remaining group (3 females, 22 males, average age 65), serum ferritin ranged 351–1957 mcg/l (mean 1113 mcg/l), transferrin saturation 21%-96% (mean 46%) and LIC 1.41–4.23 mg/g (mean 2.11 mg/g). Those with liver risk factors (including alcohol and high BMI) had higher serum ferritin (1254 vs 901 mcg/l, p LIC was significantly higher in homozygotes compared with other groups for any given ferritin concentration. Of the 93 patients, 20 homozygotes and 4 compound heterozygotes were venesected to serum ferritin Conclusion MR LIC correlates well with iron overload in HH as calculated by volume of blood removed; LIC is therefore likely to be discriminatory in non-homozygotes where additional risk factors contribute to hyperferritinaemia. Compound heterozygotes are more likely to benefit from venesection when serum ferritin is >1000 mcg/l. |
| Databáze: | OpenAIRE |
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