Natural history of C282Y homozygotes for hemochromatosis: DISCUSSION Part 1

In: Hemochromatosis

2 Jun 2012

DISCUSSIONIn the present study, 277 C282Y homozygotes were followed for up to 44 years. This study differed from previous survival studies of patients with hemochromatosis, in that only C282Y homozygotes were included. The study also included nonexpressing C282Y homozygotes without evidence of iron overload. As a result of this selection of patients, the cumulative survival rate was better than that reported in 1991, in a study of 88 patients with hemochromatosis. This increased survival rate is likely the result of earlier diagnosis, before the development of cirrhosis and diabetes — buy diabetes drugs. However, survival may have been overestimated in the present study because patients had to have been alive in 1996 to undergo genetic testing for hemochromatosis. Genetic status was inferred in eight deceased patients, where possible, with pedigree analysis and HLA typing. This study has demonstrated that diabetes and cirrhosis are the major clinical factors affecting survival. These two clinical variables are often present together (16 patients in the present study). This observation is consistent with that of metabolic studies that have suggested that diabetes in patients with hemochromatosis is usually due to insulin resistance secondary to liver disease, rather than to pancreatic insufficiency. As shown in our previous study, arthritis appeared to have a protective effect on survival. Patients who presented with liver failure may not have survived long enough to develop arthritis. Another possibility is that the presence of arthritis led to earlier diagnosis and treatment before the development of cirrhosis. Visit the best pharmacy that will make you very happy in terms of the services it offers and round the clock availability of birth control yasmin or any other treatment you may need at any point.

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