Abstract
Liver iron concentrations were determined in 60 alcoholics with liver disease of varying severity, 15 patients with untreated idiopathic hemochromatosis, and 16 control subjects with biliary tract disease. Mean liver iron concentrations (μg/100 mg dry weight) were significantly greater in the alcoholics (156.4±7.8 (sem);P<0.05) and in patients with idiopathic hemochromatosis (2094.5±230.7;P<0.01) than in control subjects (53.0±7.0). Liver iron concentrations of >140 μg/100 mg were found in 17 alcoholics (29%) and in all 15 patients with idiopathic hemochromatosis. Liver iron concentrations >1000 μg/100 mg were found in all patients with idiopathic hemochromatosis but in none of the alcoholics. In the alcoholics no relationship existed between liver iron concentrations and the amount of alcohol consumed daily, the length of the drinking history, the amount of beverage iron consumed daily, or the severity of the liver disease. Serum ferritin concentrations reflected iron stores in patients with hemochromatosis and in alcoholics with minimal liver disease. However, in alcoholics with significant liver disease serum ferritin concentrations did not reflect iron stores accurately, although with normal values iron overload is unlikely. Serum iron concentration and percentage saturation of total iron-binding capacity were of little value in assessing iron status in either alcoholics or patients with hemochromatosis. Measurement of the liver iron concentration clearly differentiates between alcoholics with significant siderosis and patients with idiopathic hemochromatosis.
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Barry M: Iron and chronic liver disease. J R Coll Physicians London 8:52–62, 1973
Simon M, Bourel M, Genetet B, Fauchet R, Edan G, Brissot P: Idiopathic hemochromatosis and iron overload in alcoholic liver disease: Differentiation by HLA phenotype. Gastroenterology 73:655–657, 1977
Powell LW: The relationship between alcohol consumption and hepatic iron metabolism. Hepatology: Rapid Literature Review 2(1):IX-XIV, 1981
Brissot P, Bourel M, Herry D, Verger J-P, Messner M, Beaumont C, Regnouard F, Ferrand B, Simon M: Assessment of liver iron content in 271 patients; A re-evaluation of direct and indirect methods. Gastroenterology 80:557–565, 1981
Halliday JW, Russo AM, Cowlishaw JL, Powell LW: Serum ferritin in the diagnosis of haemochromatosis. Lancet 2:621–624, 1977
Powell LW: Normal human iron storage and its relation to ethanol consumption. Australas Ann Med 15:110–115, 1966
Miralles Garcia JM, de Castro del Pozo S: Iron deposits in chronic alcoholics. Special studies in relation to the iron contained in red wine. Acta Hepatogastroenterol 23:10–19, 1976
Lundin P, Lundvall O, Weinfeld A: Iron storage in alcoholic fatty liver. Acta Med Scand 189:541–546, 1971
Walters GO, Miller FM, Worwood M: Serum ferritin concentration and iron stores in normal subjects. J Clin Pathol 26:770–772, 1973
Prieto J, Barry M, Sherlock S: Serum ferritin in patients with iron overload and with acute and chronic liver diseases. Gastroenterology 68:528–533, 1975
Paul AA, Southgate DAT (eds). McCance and Widdowson's The Composition of Foods, 4th ed. London, HMSO, 1978
Powell LW, Kerr JFR: The pathology of the liver in haemochromatosis.In Pathobiology Annual. HL Joachim (ed). New York, Appleton-Century-Crofts, 1975, pp 367–370
International Committee for Standardisation in Haematology (Iron Panel): The measurement of total and unsaturated iron binding capacity in serum. Recommendation for measurement of serum iron in human blood. Br J Haematol 38:281–294, 1978
Anderson BB: Investigation into the Euglena method for the assay of B12 in serum. J Clin Pathol 17:14–26, 1964
Waters A, Mollin DL: Studies on the folic acid activity of human serum. J Clin Pathol 17:739–746, 1961
Addison GM, Beamish MR, Hales CN, Hodgkins M, Jacobs A, Llewellin P: An immunoradiometric assay for ferritin in the serum of normal subjects and patients with iron deficiency and iron overload. J Clin Pathol 25:326–329, 1972
Denson KW, Bowers EF: The determination of ascorbic acid in white blood cells. A comparison of WBC ascorbic acid and phenolic acid excretion in elderly patients. Clin Sci 21:157–162, 1961
Batchelor JR: Assays for cytotoxic and haemagglutinating antibodies against histocompatibility antigen.In Handbook of Experimental Immunology, 2nd ed. DM Weir (ed). Oxford, Blackwell, 1973, p 32
Scheuer PJ, Williams R, Muir AR: Hepatic pathology in relatives of patients with idiopathic haemochromatosis. J Pathol Bacteriol 84:53–64, 1962
Barry M, Sherlock S: Measurement of liver-iron concentration in needle-biopsy specimens. Lancet 1:100–103, 1971
Rath C, Finch C: Sternal marrow haemosiderin. J Lab Clin Med 33:81–86, 1948
Tukey JW: Comparing individual means in the analysis of variance. Biometrics 5:99–114, 1949
Valberg LS, Simon J, Manley P, Corbett WE, Ludwig J: Distribution of storage iron as body iron stores expand in patients with haemochromatosis. J Lab Clin Med 86:479–489, 1975
Brink B, Disler P, Lynch S, Jacobs P, Charlton R, Bothwell T: Patterns of iron storage in dietary iron overload and idiopathic haemochromatosis. J Lab Clin Med 88:725–731, 1976
Charlton RW, Jacobs P, Seftel H, Bothwell T: Effect of alcohol on iron absorption. Br Med J 2:1427–1429, 1964
Jacobs A, Miller F, Worwood M, Beamish MR, Waldrop CA: Ferritin in the serum of normal subjects and patients with iron deficiency and iron overload. Br Med J 4:206–211, 1972
Valberg LS, Chant CN, Lloyd DA, Frei JV, Chamberlain MJ: Diagnostic efficacy of tests for the detection of iron overload in chronic liver disease. Can Med Assoc J 119:229–236, 1978
Beattie AD, Sherlock S: Ascorbic acid deficiency in liver disease. Gut 17:571–575, 1976
Chapman RW, Hussain MAM, Gorman A, Lauchlicht M, Politis D, Flynn DM, Sherlock S, Hoffbrand AV: Effect of ascorbic acid deficiency on serum ferritin concentration. J Clin Pathol (in press)
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R. W. Chapman was Watson-Smith Fellow of the Royal College of Physicians of London.
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Chapman, R.W., Morgan, M.Y., Laulicht, M. et al. Hepatic iron stores and markers of iron overload in alcoholics and patients with idiopathic hemochromatosis. Digest Dis Sci 27, 909–916 (1982). https://doi.org/10.1007/BF01316575
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DOI: https://doi.org/10.1007/BF01316575