Hemochromatosis causes
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sunny Kumar MD [2]
Overview
Causes
Hemochromatosis is due to unchecked transfer of iron into the bloodstream in the absence of increased erythropoietic needs and its toxic effects in parenchymatous organs.[1][2]
- The features of Hemochromatosis are due to presence of toxic iron in pro-oxidant form in surroundings of parenchymatous tissue cells of the liver and other organs, where it can cause oxidative damage and lead to cirrhosis, hypogonadism, diabetes, cardiomyopathy, arthropathy, and skin pigmentation.
- Hereditary hemochromatosis can occur when a person inherits two mutated copies of a gene called the HFE gene — one from each parent. Men and women have the same chance of inheriting two copies of this gene.
- Not everyone who is born with two copies of the mutated HFE gene develops the disease. Scientists do not know what percentage of people who have two copies of the mutated HFE gene develop the disease. Some studies have shown that as few as 1 in 100 people will develop symptoms. Other studies have shown that as many as 50 in 100 people may develop symptoms.
- A person with only one copy of the mutated HFE gene is usually healthy and is said to be a “carrier” of the genetic condition. Although a carrier usually does not have hemochromatosis, if both a mother and father are carriers, a child may inherit two copies of the mutated gene, one from each parent.
Following are classes which have their respective causes:
Entral:
- The entral source of hemochromatosis is hereditary hemochromatsis. Genes involved are
| Description | OMIM | Mutation | Locus |
| Haemochromatosis type 1: "classical"-haemochromatosis | 235200 | HFE | 6p21.3 |
| Haemochromatosis type 2A: juvenile haemochromatosis | 602390 | hemojuvelin ("HJV", also known as HFE2) | 1q21 |
| Haemochromatosis type 2B: juvenile haemochromatosis | 606464 | hepcidin antimicrobial peptide (HAMP) or HFE2B | 19q13 |
| Haemochromatosis type 3 | 604720 | transferrin receptor-2 (TFR2 or HFE3) | 7q22 |
| Haemochromatosis type 4 autosomal dominant haemochromatosis (all others are recessive), gene mutation | 604653 | ferroportin (SLC11A3) | 2q32 |
Paraentral:
- Paraentral haemochromatosis refers to patients who get multiple blood transfusions.
Placental:
- Placental haemochromatosis/Neonatal hemochromatosis to condition in which fetus has deposited iron in it's hepatic and or extra-hepatic tissue pathologically.[3][4]
- Gestational alloimmune liver disease is cause of fetal liver injury that occurs in all cases of Neonatal hemochromatosis.
- In fetus the level of TFR1, transferrin, and ferritin is found high.
- It is unclear what is the cause but it is believed that fetal blood extracts more iron from maternal blood.
- As the fetal liver is damaged, it causes decreased levels of Hepcidin.
References
- ↑ Pietrangelo A (2015). "Genetics, Genetic Testing, and Management of Hemochromatosis: 15 Years Since Hepcidin". Gastroenterology. 149 (5): 1240–1251.e4. doi:10.1053/j.gastro.2015.06.045. PMID 26164493.
- ↑ Salgia RJ, Brown K (2015). "Diagnosis and management of hereditary hemochromatosis". Clin Liver Dis. 19 (1): 187–98. doi:10.1016/j.cld.2014.09.011. PMID 25454304.
- ↑ Lopriore E, Mearin ML, Oepkes D, Devlieger R, Whitington PF (2013). "Neonatal hemochromatosis: management, outcome, and prevention". Prenat Diagn. 33 (13): 1221–5. doi:10.1002/pd.4232. PMID 24030714.
- ↑ Korkmaz L, Baştuğ O, Daar G, Doğanay S, Deniz K, Kurtoğlu S (2015). "Neonatal hemochromatosis in monochorionic twins". J Neonatal Perinatal Med. 8 (4): 413–6. doi:10.3233/NPM-1577113. PMID 26836824.