Talk:Hereditary haemochromatosis

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WP Spelling conventions
Crusadeonilliteracy, I am sorry for moving the page, but AFAIK Wikipedia endorses US spelling and I simply arranged for the page to follow US spelling (hemo- instead of haemo-). I personally favour (see?) the UK spelling. Will you please support a move of the page body to hemochromatosis and use haemochromatosis as a redirect? Jfdwolff 10:32, 21 Mar 2004 (UTC)


 * No, it does not endorse US spelling. Morwen 12:28, Mar 21, 2004 (UTC)

I believe that wikipedia should not and as a rule does not endorse US spelling - English originated in england. Benjaminstewart05 11:52, 12 April 2006 (UTC)

Sorry, let's rephrase that: Wikipedia uses US spelling. Could we have a vote on the correct spelling of Hemochromatosis. Jfdwolff 16:24, 21 Mar 2004 (UTC)

See also American and British English differences, where a number of ae-words are mentioned. As the vote has not received any responses, and User:Crusadeonilliteracy has not responded, I have now moved it to Hemochromatosis. Please do not revert without discussing this on the talk:hemochromatosis page, because this is getting a bit ridiculous. Jfdwolff 20:26, 22 Mar 2004 (UTC)


 * Jfdwolff, I suggest you read Wikipedia's policy on US vs British spelling before making statements about what Wikipedia does, or does not do.. From Contributing FAQ:


 * "People are writing in all sorts of English. However, it is good form to keep usage consistent within a given article. The official policy is to use British spelling when writing about British-related topics, and American for American-related topics. More general topics can use any one of the versions, but should be consistent within the article. "


 * Nobody responded to your "poll" because nobody needed to. Given that Crusadeonilliteracy was the one who did the work of merging the duplicates, it's up to him to choose which spelling to use.


 * You also only gave everyone 4 hours to respond to your call for a vote on the spelling, which is entirely unreasonable for a low-traffic page such as this.


 * -- Cyrius 04:51, Mar 23, 2004 (UTC)


 * And see the "Usage and Spelling" section of Manual of Style, especially:


 * "If an article is predominantly written in one type of English, aim to conform to that type rather than provoking conflict by changing to another."


 * -- Cyrius 07:12, Mar 23, 2004 (UTC)

Hello Cyrius, welcome to the debate. And also thanks for reverting without discussing this nicely on the talk page. Concerning the 4 hour wait, this is factually incorrect. My first message was there for several days, leaving Crusadeonilliteracy plenty of time to offer his comments.

Concerning the correct spelling, Angela was so kind to inform me about the language policy of Wikipedia, without reverting to and fro. Personally I prefer the UK spelling but I was under the impression that Wikipedia was uniformist in its spelling. If this had been discussed, instead of resorting to a revert war, I might have opened my eyes a bit earlier. Jfdwolff 19:14, 23 Mar 2004 (UTC)


 * Excuse me, I misread so I was off a day. It was 28 hours between your "can we have a vote" at 16:24, 21 Mar., and the move at 20:20 22 Mar. Hardly "several days" for the poll, and still not very long.


 * I informed you about the language policy and corrected your mistake. Why did I fix it instead of waiting for you to realize your error? Because I'm an insensitive jerk and I prefer having a problem solved quickly to making everybody happy.


 * Additionally, you copied the wrong version, so an article with UK spellings was at a US spelled title, and that just ain't right.


 * The real irony here is that I'm from the US, and loathe the UK "ae" spellings. I'm going to let your little edit of one of my comments go as an accident.


 * -- Cyrius 20:33, Mar 23, 2004 (UTC)

Hi Cyrius. No hard feelings, please. Thank you (no sarcasm) for improving on my UK English. I'm Dutch (living in the UK), so there might be the odd Dutchism there.

I'm really not sure what little edit I made in one of your comments!! I certainly don't recall doing so. Jfdwolff 16:32, 24 Mar 2004 (UTC)

Thank you all for the "English" lesson. As a person diagnoised with Hemochromatosis I find the debate trivial and insensitive to those who visit the site seeking knowledge of the disorder. WRR 22:59, 6 December 2006 (UTC)


 * That's why this is the talk page, which does not contain knowledge of the disorder but minor quibbles between the various contributors. No insensitivity was intended, and I hope your medical progress has been satisfactory. In any case, please let us know if the article itself is deficient in any way, and whether any particular information is needed. JFW | T@lk  19:05, 24 December 2006 (UTC)

Merged from Talk:Hemochromatosis
Yes, this page was moved from haemochromatosis, because that is the accepted American spelling. There were no responses on the Talk:Haemochromatosis page when I called for a vote. Please do not revert without discussing this on this page. Thank you. Jfdwolff 20:22, 22 Mar 2004 (UTC)


 * Generally, the Wikipedia convention is to let the originator of the article determine which spelling convention to use. Haemochromatosis was started in August 2002, Hemochromatosis wasn't until a month later. - Hephaestos|&#167; 04:11, 23 Mar 2004 (UTC)


 * Another problem is that this is the English Version, not the American Version. Frankly, while I admire D. Webster's many talents and towering intellect, he was not a little misguided in this respect.
 * That said, this insistence on the American only spelling (we'll not go into the fact that it was only one guy who brought this about and it has been shoved down our collective throats with out so much as 'by your leave.') is a little obnoxious, over-bearing, a little if not a lot snobbish, and has earned the enmity - well deserved I might add - of native and non-native speakers everywhere. [On a personal note, I am a Midwesterner, born in a Free State and raised in the Border States. I have extensive experience with various versions of English overseas and a graduate degree in applied lingusistics and I find this insistence on the One True Way more than a little pretentious. Our only compensation is that the anti-American everything groups are sillier. But I digress.] Let the editor choose.
 * We have enough problems without shoving this pseudo-elitists perspective down the throats of those educated in very good schools on other parts of the planet.
 * So, 'colour' reads the same as 'color', 'centre' as 'center' and so forth. I have no problem with this and have extensive experiences with non-native speakes to know that they may note the difference but do not find it a stumbling block--the insistence on only one version does create problems though. Malangthon 01:24, 16 March 2007 (UTC)

Article quality
However it's spelled, the article is too full of/dependent on medical terminology. Can someone start work on systematically correcting this, and improving the article's quality in other ways? -Fsotrain09 16:57, 19 August 2006 (UTC)


 * Are there specific edits that you can do yourself? I'm not sure how an encyclopedic article about a disorder can avoid having some if not many uses of medical terminology.  As is, many of the technical terms are linked to further articles for deeper explanations.  -- Tomlouie | talk 14:08, 29 August 2006 (UTC)

Baldness as a symptom?
Is baldness a symptom of Haemochromatosis or other iron overload disorders? Is so, maybe it should be listed as such. The reason I ask, is my doctor had me undergo iron level testing to ensure my baldness was not caused by high iron levels. 202.10.86.59 04:21, 21 October 2006 (UTC)

As far as I can tell, baldness may be caused (in part) by high iron. Hemochromatosis is only one cause of high iron. Baldness would be common to all causes of high iron.

I know this is a bit late in the debate, but my iron levels were found to be extremely high end of the scale, and I've still got all my hair :-)  Almost - instinct 13:49, 13 May 2008 (UTC)

Prostatitus or Swollen Prostate a symptom
Does anyone know if Prostatitus or urinary tract infection is a symptom?

24.68.224.30 (talk) 06:40, 11 September 2008 (UTC)

Leukemia as a symptom
In the same sense that a physician will look for HH in the face of a cirrhosis dx, recent literature now supports connections between HH and Leukemia, sometimes referenced in query results as "iron overload and leukemia" 173.164.129.250 (talk) 19:42, 13 September 2011 (UTC) jackpark

Plague
Sharon Moalem has apparently stated that haemochromatosis has been preserved on an evolutionary level as a defense against the bubonic plague. feels this should be included into this article, despite the fact that this is a highly speculative matter that has not reached wide circulation and presently has few other supporters in the field. The same researcher also claims to have linked HHC with Alzheimer's disease, a rather novel link indeed.

Not every speculative theory needs to be included into Wikipedia. This applies especially to evolutionary theories, which are untestable in their very essence (unless one can construct an experiment that lasts 800 years and exposes healthy volunteers to Yersinia pestis). JFW | T@lk  18:58, 24 December 2006 (UTC)


 * Speculation as to why more than 30% of Europeans carry Haemochromatosis mutations today more than 30x any other population deserves to be included in the epidemiology of this disease User:Evolu

No, it does not. They are many other reasonable explanations (e.g. a diet low in iron giving a survival advantage to those who avidly absorb iron). This work requires much more exposure before it's suitable for inclusion into a general encyclopedia. JFW | T@lk  21:34, 24 December 2006 (UTC)

I have to agree and disagree with both of you. There is no reason why these highly speculative hypothesis should be given a large portion of the article true, but if these do pop up in the realm of legitimate research, well, then a brief synopsis and a source can be given since this stuff does get out in the mainstream press and pop science sources. Educating (which is a primary goal of WP) involves the process of hypothesising and learning how to read the information critically. Otherwise the editing of this article and many other like it become the domain of very pushy people who leave the entire WP rationale in the dust. If you want some sort of exclusive control that will be imposed, join Citizendium. However, remember, the final decisions on articles will be made by people who have academic creditials in their respective field. Malangthon 17:59, 17 March, 2007 (EPT)

Time to get real
This section:


 * '''Imaging features
 * Clinically the disease may be silent, but characteristic radiological features may point to the diagnosis. The increased iron stores in the organs involved, especially in the liver and pancreas, result in an increased attenuation at unenhanced CT and a decreased signal intensity at MR imaging. Haemochromatosis arthropathy includes degenerative osteoarthritis and chondrocalcinosis. The distribution of the arthropathy is distinctive, but not unique, frequently affecting the second and third metacarpophalangeal joints of the hand.

simply draws attention to a glaring problem: The people who can understand this will not be reading WP. The rest of them who will be reading WP can not understand it. The jargon must be simplified. A physician is nothing if not able to educate the patient, What ethical physician who can understand this would ever give this explanation to a patient who has turned a nice brownish red colour and can not seem to find energy to do much at all? Malangthon 19:04, 17 March, 2007 (EPT)

And it has no source cited. Malangthon 20:43, 17 March, 2007 (EPT)


 * I think the goal of wikipedia is to undo ignorance. Readers who don't know what words like arthroplasty mean can look them up with linked text (cross-references).  What makes WP so powerful, IMHO, is the ability to crossreference everything.  Wasn't that the whole point of hypertext originally?  There's no excuse for not knowing what a word means any more, when you don't even have to pull out a dictionary.  Just click on the word you don't know.  How hard is that to do?  I would have been besides myself if I could have done that in school!


 * Of course you would never talk like this to a patient. At the same time, there are laypeople who know what these words mean--have you ever listened to NPR?  I think we shouldn't be obligated to use five words when one will do, as long as someone can link to the definition easily enough.  I agree that we should make sure each big word is at least linked to another page, if not explained on the original page.--Dr.michael.benjamin 03:58, 31 May 2007 (UTC)

External Sources
FYI: The link to bioiron International Bioiron Society is members only. Malangthon 20:43, 17 March, 2007 (EPT)

Screening
This section was a bit sparse and had no sources. I did a rewrite of this section employing authoritative sources. Malangthon 09:16, 18 March, 2007 (EPT)

Histopathology
This section was a bit cryptic so I did a rewrite expanding its coverage and using authoritative sources. Malangthon 09:16, 18 March, 2007 (EPT)

Discussion reorganisation
Hope I am not being too intrusive but as I read this it became clear that it was rather more organic than is helpful in following the discussion. I have not deleted anything but have simply rearranged the topics under their related categories. My apologies if I have stepped on toes, but prehaps the discussion should be, like the article, a bit more organised. Malangthon 09:31, 18 March, 2007 (EPT)

Article overview - WP guidelines, quality and language
Intro – one para. Too brief for an article of this length possibly.

History – one para. Too brief?

S & S – I say it is fine, could use a little more elaboration but the sources are good (Although Jfdwolff has disagreed but see our discussion under "Sources").

Diagnosis – intro para plus
 * Imaging feature – No sources. It could be interesting and informative if this were developed more. One problem is that the language is very jargonish. Providing a simplified version for the technical terminology would help John Q Public to better understand this. I had a few friends look at this and they could not make heads nor tails of it – not what WP is shooting for. I have spent some time in imaging technology to have an idea what it is trying to get across but it is technically dense.


 * Chemistry – 4 para. Not really the best title, could be “Lab tests” as in the “Chemistry of lab tests” or “Clinical Lab Testing” (a common and traditional, though formal appellation) or “Lab work-up” (colloquial but common language). The first two tests are covered fairly well without danger of the reader’s eye glazing over and have definitive authoritative sources. The other tests could be elaborated somewhat and related to the overall topic since these concerns do show up in long-term effects (see “Complications” and “Screening” for example).


 * Histopathology – 1 para. Historically and clinically this section is pertinent. I have elaborated on it from the original text with good and authoritative sources, which can be accessed for greater detail by pedestrian and physician alike.


 * Screening – 3 para (counting the bullet points) Hits the main points, uses authoritative sources and is succinct, in my humble opinion anyway. I elaborated on “genetic screening” since it is an important part of this article and given the situation, important information to know.


 * Differential diagnosis – 3 para. This is, in my opinion, an important part of the article. I think it hits the high points but needs elaboration and sources

Summary: May I suggest raising the formatting one level for each of these (i.e. remove one = from each side) to allow for elaboration down the line given the complexity of these issues or simply to note their strategic position in the article.

Epidemiology – 1 para. Intro is undersourced in my opinion.

Genetics – While this is well resourced, we could use more accessible sources as well. (The technical nature of the language of the sources placed it well outside the reach of the common reader.) I have provided an intro to accomplish this (and tested it on readers). A further note, given that epidemiology is basically the study of patterns, sources, and causes of disease, this seems to me to be a subcategory of epidemiology. We could achieve this by raising the level of Epidemiology or lowering that of Genetics. I prefer the former.

Pathophysiology – 3 para including 2 subsections. Begins well. I am not sure it has been fully sourced. I have not read the one citation in the introduction as yet.


 * Crypt cell hypothesis – Crypt cell is cryptic to say the least. No sources and in need of help with the technical jargon.


 * Hepcidin-ferroportin axis – same problem as crypt cell hypothesis. Neither demonstrably achieve many of the WP goals.

Complications – I wrote this missing section with an authoritative source. I was surprised it was not there. It hits the clinical high points. I had it test read and it is OK. As more information becomes available, it will grow surely.

Treatment – this was unsourced so I provided a definitive source. Malangthon 10:17, 18 March, 2007 (EPT)

Irish, British Isles Descent
The Irish, Welsh, Scots, and Brits are generally affected more by Hemochromatosis than other ethnic groups, but I wasn't sure how to put this, so I mentioned Northern European and Hiberno-English as the two most accurate descriptors. Also, it is noteworthy that the statistic of 1 in every 300-400 people are effected by the disease is because pre-menopausal women are generally not effected the disease, and post-menopausal women generally do not suffer the same effects because of changes in diet, lifestyle, and so on, of men. —The preceding unsigned comment was added by Michael brazell (talk • contribs).
 * "especially people of Irish, Scottish, Welsh and English descent."

Surely it would be more concise just to say "British" here? Irish, Scottish, Welsh and English together make up the British Isles. WikiReaderer 11:21, 28 August 2007 (UTC)

No. It really would not. 94.198.120.51 (talk) 20:13, 30 May 2012 (UTC)

Cleanup sources
After Malangthon's edits in March, the article has not been cleaned up. My concern it the enormous reliance on website material while there are excellent peer-reviewed studies available, e.g. last year's review by Pietrangelo in NEJM. JFW | T@lk  06:41, 14 January 2008 (UTC)


 * HFE-related disease in homozygotes (liver and joint) in 28% of males, much less in females. This needs to be cited. JFW | T@lk  14:15, 17 January 2008 (UTC)

Screening
Using a ferritin of 1000 as a cutoff: JFW |  T@lk  00:41, 25 March 2008 (UTC)

punctuation
Under "Signs and symptoms"
 * Liver cirrhosis (with an increased risk of hepatocellular carcinoma Liver disease is always preceded by evidence of liver dysfunction including elevated serum enzymes specific to the liver.

there is a left parenthesis with no right one. I'm not sure where the right one should go. Also, I get the idea that there ought to be punctuation between "carcinoma" and "Liver" (maybe because "liver" got capitalized). Sorry I couldn't fix it. anon 01:22, 24 April 2008 (UTC)

"treatment" paragraph
Some of the content of this section needs qualifying. eg "treatment includes". I'm only a patient not a doctor, but this position allows me to know consensus is far from reached in terms of what restrictions are required in diet eg one consultant bans red meat, the next (in the same dept) say oh thats nonsense. Detail specifying WHY patients might drink less alcohol and more tea would be helpful to those readers who have looked up this article two days after being diagnosed.  Almost - instinct 23:30, 14 May 2008 (UTC)

Promote to high importance
Hemochromatosis is one of the classic textbook genetic diseases, and the very large number of page hits this article is receiving reflects its importance. Its not just that the disease is common in European populations. The importance if the disease is also reflected in the fact that it is so often used to provide examples of how genetic variation, compound heterozygosity, environmental co-factors, and so forth affect the outcome of genetic disease in general. So I am suggesting, Mid importance in medicine as a whole, but high importance in genetics. Metzenberg (talk) 08:49, 20 April 2009 (UTC)

what hemochromotosis?
i was watching tv when i saw a man my husbands age on a mystery diagnosis tlc channel and he was talking about symptoms of this disease. i was so shocked he had all symptoms,although most people could have symptoms to alot of different diseases,i know but he had every physical and mental symptoms! i really feel this is the answer we been looking for. he has to take a high iorn blood test and if it is high maybe he can get help ,no doctors will mess with it because he has no insurance. im willing to fight til someone helps him! he has taken cara of my children and i for 17 yrs and i need help from anyone who can help me so he can work on an easy cure,no drugs no surgery only a blood transfussion called a FLABOTOMY??????? —Preceding unsigned comment added by 69.243.158.47 (talk) 20:47, 15 May 2009 (UTC)

no means of iron exretion
while their is no means of iron excretion, the wording may be misleading. Iron is shed along with epithelial cells from the mucosa of the GI. Therefore there is a mechanism by which we lose iron. —Preceding unsigned comment added by AriaNo11 (talk • contribs) 21:43, 27 July 2009 (UTC)

Also menstruation. 94.198.120.51 (talk) 20:16, 30 May 2012 (UTC)

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