New researchers from Edith Cowan University (ECU) have identified a key link between arthritis and the risk of severe liver disease in patients with Australia's most common genetic disease. An estimated 100000 Australians carry a high-risk genotype for hemochromatosis, a disease that affects Nordic descendants, manifested in the accumulation of too much iron in the body. It can lead to many complications, the most serious of which is advanced liver fibrosis, which affects the liver and may lead to cirrhosis and liver cancer.
However, early detection of advanced liver fibrosis can help clinicians identify those most at risk and reduce the impact or occurrence of future complications.
ECU researchers, in collaboration with colleagues at qimr berghofer Institute of medicine, found that arthritis was a powerful predictor of clinically important liver problems in patients with hemochromatosis.
Hemochromatosis is a disease in which excess iron accumulates to harmful levels in the body. Without treatment, this situation can lead to overload, and the accumulation of iron can damage many parts of the body, including the liver, heart, pancreas, endocrine glands and joints.
The study, published in the Mayo Clinic Proceedings, studied 112 patients with hemochromatosis.
Of the 19 patients with advanced stage 3-4 liver fibrosis, 84% also had arthritis. However, of the 65 subjects without arthritis, only 5% had advanced liver fibrosis.
Senior author Professor John olynyk said the results had many implications for those with or at risk of developing hemochromatosis.
"Since liver fibrosis will improve with treatment, it is important to accurately determine whether there is advanced liver fibrosis when evaluating patients. We recommend that patients with hemochromatosis with arthritis be properly evaluated to determine whether there is advanced liver fibrosis," he said.
The study could also help many people avoid unnecessary surgery. "Those with hemochromatosis but without arthritis at the time of diagnosis are highly unlikely to have advanced liver fibrosis, which may determine the need for an initial liver biopsy. Instead, they can monitor the development of fibrosis through non-invasive methods," he said
The association with arthritis can help diagnose more patients with hemochromatosis, which is often difficult to diagnose because many symptoms are relatively nonspecific and common in the general population. When people with the right background develop arthritis or liver disease, the potential hemochromatosis should always be evaluated - especially when the cause of the problem is unclear.
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