Screening Strategies for Hemochromatosis
Authors: Pradyumna D. Phatak
Journal: Annals of Internal Medicine (2009)

Letters21 April 2009Screening Strategies for HemochromatosisPradyumna D. Phatak, MD, Herbert L. Bonkovsky, MD, and Kris V. Kowdley, MDPradyumna D. Phatak, MDFrom Rochester General Hospital, Rochester, NY 14621; Carolinas HealthCare System, Charlotte, NC 28232; and Virginia Mason Medical Center, Seattle, WA 98101.Search for more papers by this author, Herbert L. Bonkovsky, MDFrom Rochester General Hospital, Rochester, NY 14621; Carolinas HealthCare System, Charlotte, NC 28232; and Virginia Mason Medical Center, Seattle, WA 98101.Search for more papers by this author, and Kris V. Kowdley, MDFrom Rochester General Hospital, Rochester, NY 14621; Carolinas HealthCare System, Charlotte, NC 28232; and Virginia Mason Medical Center, Seattle, WA 98101.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-150-8-200904210-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We appreciate Dr. Thachil's comments regarding the value of serum ferritin measurement as an adjunctive test to serum transferrin–iron saturation in the diagnostic algorithm for hereditary hemochromatosis. We agree that the serum ferritin level is the most useful noninvasive measure of body iron stores in patients with hemochromatosis and can help determine the need for therapeutic intervention. Waalen and colleagues (1) have recommended a ferritin-only screening approach, using a relatively high serum ferritin threshold value of 1000 μg/L (1). Of 59 patients identified in a primary care clinic by using this serum ferritin threshold during a population screening ...References1. Waalen J, Felitti VJ, Gelbart T, Beutler E. Screening for hemochromatosis by measuring ferritin levels: a more effective approach. Blood. 2008;111:3373-6. [PMID: 18025154] CrossrefMedlineGoogle Scholar2. Adams PC, Reboussin DM, Press RD, Barton JC, Acton RT, Moses GC, et al. Biological variability of transferrin saturation and unsaturated iron-binding capacity. Am J Med. 2007;120:999.e1-7. [PMID: 17976429] CrossrefMedlineGoogle Scholar3. Allen KJ, Gurrin LC, Constantine CC, Osborne NJ, Delatycki MB, Nicoll AJ, et al. Iron-overload-related disease in HFE hereditary hemochromatosis. N Engl J Med. 2008;358:221-30. [PMID: 18199861] CrossrefMedlineGoogle Scholar4. Asberg A, Hveem K, Thorstensen K, Ellekjter E, Kannelønning K, Fjøsne U, et al. Screening for hemochromatosis: high prevalence and low morbidity in an unselected population of 65,238 persons. Scand J Gastroenterol. 2001;36:1108-15. [PMID: 11589387] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Pradyumna D. Phatak, MD; Herbert L. Bonkovsky, MD; Kris V. Kowdley, MDAffiliations: From Rochester General Hospital, Rochester, NY 14621; Carolinas HealthCare System, Charlotte, NC 28232; and Virginia Mason Medical Center, Seattle, WA 98101.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoHereditary Hemochromatosis: Time for Targeted Screening Pradyumna D. Phatak , Herbert L. Bonkovsky , and Kris V. Kowdley Screening Strategies for Hemochromatosis Jecko Thachil Metrics 21 April 2009Volume 150, Issue 8Page: 566KeywordsAlgorithmsConflicts of interestFerritinFibrosisHemochromatosisSerum ferritin levels ePublished: 21 April 2009 Issue Published: 21 April 2009 Copyright & PermissionsCopyright © 2009 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...