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Prepublished online as a Blood First Edition Paper on April 17, 2002; DOI 10.1182/blood-2001-11-0132.

Submitted November 30, 2001
Accepted March 9, 2002
Autosomal dominant reticulo-endothelial iron overload associated with a three base pair deletion in the Ferroportin 1 gene (SLC11A3)
Vinod Devalia, Kymberley Carter, Ann P Walker, Stephen J Perkins, Mark Worwood*, Alison May, and James S Dooley
Department of Haematology, Princess of Wales Hospital, Bridgend, United Kingdom
Department of Haematology, University of Wales College of Medicine, Cardiff, United Kingdom
Centre for Hepatology, Department of Medicine, Royal Free and University College Medical School, London, United Kingdom
Department of Biochemistry and Molecular Biology, Royal Free and University College Medical School, London, United Kingdom
* Corresponding author; email: worwood{at}cardiff.ac.uk.
We describe a family with autosomal dominant inheritance of increased body iron stores characterised by raised serum ferritin concentration and normal transferrin saturation. Liver biopsy showed iron deposition in Kupffer cells without fibrosis. The clinical features of HFE-related haemochromatosis were absent as were the C282Y and H63D mutations. Venesection therapy was poorly tolerated suggesting a defect in iron release from reticuloendothelial stores. A three base pair deletion in exon 5 of the ferroportin 1 gene (SLC11A3) predicting V162del was found in affected members but not in unaffected individuals or in 100 control subjects. Consensus structural predictions of the transmembrane helices show that the deletion is in the extracellular loop between the third and fourth predicted transmembrane helices and lies within a spatial cluster of other known ferroportin 1 mutations. These results indicate that this extracellular cluster is functionally important for iron transport and its disruption leads to iron overload.

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