- Phlebotomy remains the most important treatment for hereditary hemochromatosis (HH), but emerging therapies may have a role for some patients, according to a new clinical guideline from the American College of Gastroenterology.
Why this matters
- HH is 1 of the most common genetic disorders affecting people with northern European ancestry, resulting in excess iron in tissues and organs.
- Family members of patients with HH should also receive screening.
- Phlebotomy should be the first-line HH treatment.
- Patients intolerant of or refractory to treatment.
- Patients who might be harmed because they have severe anemia or congestive heart failure.
- Recommended treatment for these patients is iron chelation.
- Proton pump inhibitors (PPIs) should not be used routinely as the primary HH treatment.
- Liver transplant referral should be considered for patients with HH who also have end-stage liver disease or hepatocellular carcinoma.
- Quality of evidence for iron chelation, PPI, and liver transplant recommendations is low; further research is very likely to affect the confidence in estimates of clinical effect.