Tissue and urinary haemosiderin in chronic leg ulcers.
OBJECTIVE
The aim of this study was to assess the relationship between urinary and tissue haemosiderin in chronic leg ulcers, and its value as a diagnostic test for venous ulceration.


METHODS
45 patients with chronic leg ulcers were recruited to the study (24 venous, 6 ischaemic, 6 lymphoedematous, 5 rheumatoid and 4 sickle cell). Punch biopsy of the ulcer edge was taken and early morning urine samples were collected. Positive Prussian-blue urinary haemosiderin granules were measured with a haemocytometer following Perls' staining. The percentage area of histological section staining positively with Perls' was measured using image analysis.


RESULTS
84 urine samples and 46 ulcer biopsies were collected. Urinary haemosiderin was present in 92% of venous ulcer patients, but was absent in the ischaemic ulcer patients (p<0.0001). Significantly more urinary haemosiderin granules were detected in venous ulcer patients compared with patients who had lymphoedema (p<0.05). Tissue haemosiderin was detected in all ulcer types investigated. No correlation was found between the amounts of haemosiderin deposited in the tissue and the amount found in urine (r(2)=0.06).


CONCLUSIONS
Haemosiderin is present in the urine of most patients with venous ulcers but not in ischaemia ulcers.
Tan
J
J
St. Thomas' Hospital, Academic Department of Surgery, Cardiovascular Division, 1st Floor, North Wing, Lambeth Palace Road, London SE1 7EH, UK. justin.tan@yahoo.co.uk
Smith
A
A
Abisi
S
S
Eastham
D
D
Burnand
K G
KG
D000755:Anemia, Sickle Cell / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000652:urine; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000652:urine; D015415:Biomarkers / Q000378:metabolism / Q000652:urine; D001706:Biopsy; D002908:Chronic Disease; D003937:Diagnosis, Differential; D006485:Hemosiderin / Q000378:metabolism* / Q000652:urine; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000652:urine; D007871:Leg Ulcer / Q000209:etiology* / Q000378:metabolism / Q000473:pathology / Q000652:urine; D008209:Lymphedema / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000652:urine; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D012867:Skin / Q000378:metabolism* / Q000473:pathology; D014689:Venous Insufficiency / Q000150:complications / Q000175:diagnosis* / Q000378:metabolism / Q000652:urine
D015415:Biomarkers; D006485:Hemosiderin