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Science Forum Index » Medicine - Nursing Forum » Degree of the Iron Overload
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| ironjustice |
 Posted: Fri Feb 08, 2008 6:15 am |
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J Rheumatol. 2007 Dec 1; : 18061976
The Hand Arthropathy of Hereditary Hemochromatosis Is Strongly
Associated with Iron Overload.
[My paper] Luca Valenti , Anna Fracanzani , Valeria Rossi , Clementina
Rampini , Edoardo Pulixi , Massimo Varenna , Silvia Fargion , Luigi
Sinigaglia
OBJECTIVE:
To analyze the clinical characteristics and genetic background
associated with the presence of hand arthropathy, as determined by
radiological findings, in Italian patients with hereditary
hemochromatosis (HHC).
METHODS:
In 88 consecutive unselected patients with phenotypically expressed
HHC, joint involvement was systematically evaluated in plain
radiographs of hands, wrists, lumbar spine, pelvis, and knees. Risk
factors considered were age, sex, body mass index, alcohol abuse,
organ involvement at other sites, and indices of iron overload,
including ferritin, transferrin saturation, and iron removed to reach
depletion. HFE genotype was also considered. The independent role of
risk factors was tested by logistic regression analysis.
RESULTS:
Thirty-two subjects (36%) showed signs of metacarpophalangeal (MCP)
arthropathy. Intercarpal, radiocarpal, and chondrocalcinosis were less
frequent and occurred in association with MCP arthropathy. At
multivariate analysis MCP arthropathy was independently associated
with older age [odds ratio (OR) 1.20, 95% confidence interval (CI)
1.1-1.33/yr; p = 0.0001], higher ferritin levels at diagnosis (OR
4.17, 95% CI 1.60-13.9 for values > 1000 ng/ml; p = 0.008), the
presence of the C282Y +/+ and C282Y/H63D HFE genotypes (OR 2.69, 95%
CI 1.09-7.87; p = 0.04), and higher percentage transferrin saturation
(OR 1.05, 95% CI 1-1.1; p = 0.05). The severity of arthropathy was
independently associated with older age (p = 0.03) and higher ferritin
values (p = 0.05).
CONCLUSION:
MCP arthropathy together with a typical pattern of joint involvement
is observed in one-third of unselected patients with HHC, and is
influenced by the duration and degree of the iron overload.
Who loves ya.
Tom
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