Is iron overload in alcohol-related cirrhosis mediated by hepcidin?
In this case report we describe the relationship between ferritin levels and hepcidin in a patient with alcohol-related spur cell anemia who underwent liver transplantation. We demonstrate a reciprocal relationship between serum or urinary hepcidin and serum ferritin, which indicates that inadequate hepcidin production by the diseased liver is associated with elevated serum ferritin. The ferritin level falls with increasing hepcidin production after transplantation. Neither inflammatory indices (IL6) nor erythropoietin appear to be related to hepcidin expression in this case. We suggest that inappropriately low hepcidin production by the cirrhotic liver may contribute substantially to elevated tissue iron stores in cirrhosis and speculate that hepcidin replacement in these patients may be of therapeutic benefit in the future.
Iqbal
Tariq
T
Department of Gastroenterology, University Hospital Birmingham, Vincent Drive, Birmingham B15 2TH, UK. t.h.iqbal@bham.ac.uk
Diab
Azzam
A
Ward
Douglas G
DG
Brookes
Matthew J
MJ
Tselepis
Chris
C
Murray
Jim
J
Elias
Elwyn
E
D000740:Anemia / Q000378:metabolism / Q000601:surgery; D023181:Antimicrobial Cationic Peptides / Q000097:blood*; D005260:Female; D005293:Ferritins / Q000097:blood; D064451:Hepcidins; D006801:Humans; D007501:Iron / Q000378:metabolism; D019190:Iron Overload / Q000209:etiology*; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D016031:Liver Transplantation; D008875:Middle Aged
D023181:Antimicrobial Cationic Peptides; C578702:HAMP protein, human; D064451:Hepcidins; D005293:Ferritins; D007501:Iron