EASL Clinical Practice Guidelines on haemochromatosis.
Level 5 - mechanism / opinion, no new human data
Clinical practice guideline and expert consensus without reported primary trial data or systematic meta-analysis in the abstract
PubMed 35662478 · doi:10.1016/j.jhep.2022.03.033
What was done
The European Association for the Study of the Liver (EASL) established clinical practice guidelines defining diagnostic criteria, staging approaches, and phlebotomy treatment targets for haemochromatosis.
What was found
The abstract details recommended diagnostic cutoffs and therapeutic targets rather than primary numerical trial data: - In HFE p.Cys282Tyr homozygotes: Transferrin saturation (TSAT) >45% and ferritin >200 μg/L for females; TSAT >50% and ferritin >300 μg/L for males and postmenopausal females define provisional iron overload sufficient for diagnosis. - In non-p.Cys282Tyr genotypes: Diagnosis requires demonstration of hepatic iron overload by MRI or liver biopsy alongside elevated TSAT and ferritin. - Treatment targets: Serum ferritin <50 μg/L during the induction phase of phlebotomy and <100 μg/L during the maintenance phase. - Advanced liver fibrosis requires inclusion in a surveillance programme for hepatocellular carcinoma.
Why it matters
This guideline standardizes diagnostic laboratory thresholds based on sex and genotype and clarifies phlebotomy endpoints to prevent progression to cirrhosis and hepatocellular carcinoma.
Limits
The abstract does not provide the literature search strategy, systematic review methodology, grading metrics for specific recommendations, or primary outcome statistics supporting the selected cutoff values.
Cited by
- supports Periodic blood donation helps manage iron overload in people with hemochromatosis.