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Letter to the Editor
Editor, – I read the article about testing for HFE-related haemochromatosis with interest (Aust Prescr 2011;34:73-6). Over the last 10 years I have ordered ferritin tests in over 1211 individual patients – 229 of them were found to have abnormally elevated ferritin levels. Haemochromatosis gene testing was ordered for 120 of them and there were 47 positive results. This means a significant cohort of patients with elevated ferritin do not have a positively identified mutation. My casual observation seems to give the impression that a significant number of these patients are Asian people.
Anecdotally, diabetes and lipid control in many of these patients improved when they started donating blood regularly.
My hypothesis is that:
- there are more genotypes yet to be discovered which are responsible for elevated ferritin levels in Asian people
- this (undetected and untreated) elevated ferritin may deposit in the pancreas and liver, and to some extent contributes to the high rate of diabetes and fatty livers that are so prevalent in Asian people.
Unfortunately, this is just a hunch and I do not have the detailed breakdown of these tests.
Chenault Doug Lee
Erindale Medical Practice, ACT