Therapeutic venesection at the Australian Red Cross Blood Service: Impact of the High Ferritin Application on management of hereditary haemochromatosis
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© The Royal Australian College of General practitioners 2015. Background Therapeutic venesection is an established treatment for hereditary haemochromatosis. The C282Y homozygotes and C282Y/H63D compound heterozygotes are the most likely human haemochromatosis protein (HFE) variants to cause iron overload. The principal indications for treatment include iron overload, which is detected through measurement of hepatic iron concentration or a liver biopsy, or suspected iron-overload on the basis of elevated serum ferritin levels. Venesection is not indicated for other HFE genetic variants or in patients with isolated hyperferritinaemia in the absence of the main HFE gene mutations. The Australian Red Cross Blood Service provides a therapeutic venesection program. Since January 2013, referral has been conducted electronically using the novel, web-based High Ferritin Application. Objectives The aim of this article is to provide information regarding implementation of the High Ferritin Application and document its impact on referral patterns. Discussion This referral process is based on nationally endorsed, evidencebased algorithms, which have markedly reduced the number of unnecessary therapeutic venesections. An estimated 4000 unnecessary venesections are averted each year and this equates to a saving of $1.4 million.
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Goot, K.; Hazeldine, S.; Bentley, P.; Olynyk, John; Crawford, D. (2012)Background: Elevated serum ferritin is commonly encountered in general practice. Ninety percent of elevated serum ferritin is due to noniron overload conditions, where venesection therapy is not the treatment of choice. ...
Nadakkavukaran, I.; Gan, E.; Olynyk, John (2012)Hereditary haemochromatosis (HH) is a common autosomal recessive disorder of iron overload in Caucasian populations. Clinical manifestations usually occur in individuals homozygous for the C282Y mutation in the HFE gene ...
Higher ferritin levels, but not serum iron or transferrin saturation, are associated with Type 2 diabetes mellitus in adult men and women free of genetic haemochromatosisYeap, B.; Divitini, M.; Gunton, J.; Olynyk, John; Beilby, J.; McQuillan, B.; Hung, J.; Knuiman, M. (2015)Context - Iron overload predisposes to diabetes and higher ferritin levels have been associated with diabetes. However, it is unclear whether ferritin reflects differences in iron-related parameters between diabetic and ...