Hemochromatosis Flashcards
(10 cards)
Family members, particularly first-degree, of patients diagnosed w/ HH should be screened for HH
strong, moderate evidence
Suggest against the routine surveillance for HCC among patients w/ HH w/ stage 3 fibrosis or less
conditional, very low evidence
Recommend individuals w/ the H63D or S65C mutation in the absence of C282Y mutation should be counseled that they are not at increased risk or iron overload
conditional, very low evidence
Suggest against further genetic testing among patients w/ iron overload who tested negative for the C282Y and H63D alleles
conditional, very low evidence
Suggest a non-con MRI be used to non invasively measure liver iron concentration, in the non-C282Y homozygote w/ suspected HH. If there is a concomitant need to stage hepatic fibrosis or evaluate for alternate liver diseases, then liver biopsy is the preferred method to determine HIC
conditional, low evidence
Recommend that phlebotomy be used as the first-line treatment in patients diagnosed w/ HH, as determined by C282Y homozygosity or C282Y/H63D compound heterozygosity
strong, moderate evidence
Recommend against chelation as the first-line therapy for HH, given the effectiveness of phlebotomy, the associated side effects of chelation including hepatic and renal toxicity, and the relatively small sample size of clinical trials supporting chelation
strong, low evidence
Recommend the use of iron chelation for the treatment of HH in the patient who is intolerant or refractory to phlebotomy or when phlebotomy has the potential for harm, such as in patients w/ severe anemia or CHF
strong, low evidence
Recommend against the routine use of PPIs as the primary treatment of HH
strong, low evidence
Recommend that liver transplant be considered in patients w/ HH who have decompensated cirrhosis or HCC
strong, low evidence
