Semiquantitative and qualitative assessment of hepatic iron in patients with chronic viral hepatitis: relation with grading, staging and haemochromatosis mutations.
BACKGROUND
Hepatic iron overload is a common but still poorly characterized finding in patients with chronic viral hepatitis.


OBJECTIVE
To evaluate lobular and cellular distribution of iron in patients with chronic viral hepatitis, the relation between hepatic iron distribution, grading and staging, and the frequency of haemochromatosis gene mutations.


METHODS
Thirty-four patients with chronic viral hepatitis and iron overload; 34 matched chronic viral hepatitis controls without iron overload; 139 healthy controls.


METHODS
Hepatic iron was assessed by hepatic iron concentration and Deugnier's score, histological grading and staging by Ishak's score, and frequency of haemochromatosis gene mutations by polymerase chain reaction-restriction assays.


CONCLUSIONS
Iron deposits were found in hepatocytes (94% of the patients), sinusoidal tracts (88%) and portal cells (59%). In 41%, iron deposits were homogeneously distributed in the hepatic specimen. Hepatocytic iron showed a decreasing gradient from Rappaport's zone 1 to 3. Heavy alcohol intake influenced the distribution rather than the amount of hepatic iron by increasing sinusoidal iron. Haemochromatosis gene mutations were more frequent in chronic viral hepatitis patients with iron overload than in those without iron overload and in healthy controls suggesting they contribute to pathogenesis of hepatic iron accumulation. The correlation between hepatic fibrosis and portal iron supports the fibrogenetic role of iron in chronic viral hepatitis.
Vergani
A
A
Department of Internal Medicine, S. Gerardo Hospital, Monza, Milan, Italy.
Bovo
G
G
Trombini
P
P
Caronni
N
N
Arosio
C
C
Malosio
I
I
Fossati
L
L
Roffi
L
L
Piperno
A
A
D000328:Adult; D000368:Aged; D001706:Biopsy; D005260:Female; D005805:Genes, MHC Class I / Q000235:genetics; D006680:HLA Antigens / Q000235:genetics; D006432:Hemochromatosis / Q000145:classification / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D000071020:Hemochromatosis Protein; D019694:Hepatitis B, Chronic / Q000145:classification / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000145:classification / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D015395:Histocompatibility Antigens Class I / Q000235:genetics; D006801:Humans; D007501:Iron / Q000032:analysis / Q000378:metabolism*; D019190:Iron Overload / Q000145:classification / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D008099:Liver / Q000737:chemistry / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008565:Membrane Proteins; D008875:Middle Aged; D009154:Mutation / Q000235:genetics; D016133:Polymerase Chain Reaction
C103673:HFE protein, human; D006680:HLA Antigens; D000071020:Hemochromatosis Protein; D015395:Histocompatibility Antigens Class I; D008565:Membrane Proteins; D007501:Iron