Alcohol consumption, hepatic iron load and the risk of amoebic liver abscess: a case-control study.
OBJECTIVE
It is unknown why most amoebic liver abscess (ALA) cases occur in alcohol drinkers. In experimental studies, the presence of 'iron' potentiates the in-vitro growth of Entamoeba histolytica (E. histolytica), and is also known to increase its in-vivo invasiveness in animal infections. Chronic alcoholism increases the hepatic iron deposition. We hypothesized that ALA occurs more commonly in livers with a high iron load as in alcoholics. To test this hypothesis we compared the levels of iron between ALA and non-ALA cases belonging to alcoholic and non-alcoholic groups.


METHODS
Out of a total of 48 ALA cases, 34 (70%) were alcoholics and 14 (30%) were non-alcoholics. After applying exclusion criteria, serum iron and liver iron stores were quantified in 20 ALA cases (10 alcoholic and 10 non-alcoholics) and compared with 20 non-ALA cases (10 alcoholics and 10 non-alcoholics).


RESULTS
All patients of ALA had serum iron values within the normal range but higher than non-ALA cases. In the liver tissue, most patients with ALA had higher (grade II or III) iron deposition, than non-ALA cases (mostly grade I). Thus, patients with ALA, with or without alcohol indulgence, had higher iron levels when compared to the non-ALA cases.


CONCLUSIONS
It appears that the higher incidence of ALA in alcoholic livers is possibly due to their higher iron content.
Makkar
Ravinder P S
RP
Department of Medicine, Sitaram Bhartia Institute of Science and Research, India.
Sachdev
Gopal Kr
GK
Malhotra
Veena
V
D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000378:metabolism; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D019190:Iron Overload / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D008099:Liver / Q000378:metabolism / Q000473:pathology; D008101:Liver Abscess, Amebic / Q000209:etiology / Q000503:physiopathology*; D008107:Liver Diseases / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012306:Risk