Amir Qaseem, MD, PhD, MHA; Mark Aronson, MD; Nick Fitterman, MD; Vincenza Snow, MD; Kevin B. Weiss, MD, MPH; Douglas K. Owens, MD, MS; for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians*
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Current Author Addresses: Drs. Qaseem and Snow: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.
Dr. Aronson: 330 Brookline Avenue, Boston, MA 02215.
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Hereditary hemochromatosis is a genetic disorder of iron metabolism. Diagnosis of hereditary hemochromatosis is usually based on a combination of various genetic or phenotypic criteria. Decisions regarding screening are difficult because of the variable penetrance of mutations of the HFE gene and the absence of any definitive trials addressing the benefits and risks of therapeutic phlebotomy in asymptomatic patients or those with only laboratory abnormalities. The purpose of this guideline is to increase physician awareness of hereditary hemochromatosis, particularly the variable penetrance of genetic mutations; aid in case finding; and explain the role of genetic testing. This guideline provides recommendations based on a review of evidence in the accompanying background paper by Schmitt and colleagues. The target audience for this guideline is internists and other primary care physicians. The target patient population is all persons who have a probability or susceptibility of developing hereditary hemochromatosis, including the relatives of individuals who already have the disease.
*This paper, written by Amir Qaseem, MD, PhD, MHA; Mark Aronson, MD; Nick Fitterman, MD; Vincenza Snow, MD; Kevin B. Weiss, MD, MPH; and Douglas K. Owens, MD, MS, was developed for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians (ACP): Douglas K. Owens, MD, MS (Chair); Mark Aronson, MD; Patricia Barry, MD, MPH; Donald E. Casey Jr., MD, MPH, MBA; J. Thomas Cross Jr., MD, MPH; Nick Fitterman, MD; E. Rodney Hornbake, MD; Katherine D. Sherif, MD; and Kevin Weiss, MD, MPH (Immediate Past Chair). Approved by the ACP Board of Regents on 16 July 2005.
Table. Prevalence of Hereditary Hemochromatosis in Primary Care Settings
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Qaseem A, Aronson M, Fitterman N, Snow V, Weiss KB, Owens DK, et al. Screening for Hereditary Hemochromatosis: A Clinical Practice Guideline from the American College of Physicians. Ann Intern Med. 2005;143:517–521. doi: 10.7326/0003-4819-143-7-200510040-00010
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Published: Ann Intern Med. 2005;143(7):517-521.
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