title: Gastric siderosis: An under-recognized and rare clinical entity.
abstract: The increased deposition of iron in gastric mucosa is known as gastric siderosis. It is believed that the only regulated step of the iron metabolism cycle occurs during absorption in the small intestine. Once this system becomes overwhelmed due to either local or widespread iron levels, then iron can be absorbed very quickly by a passive concentration-dependent mechanism. This excess iron is initially stored in the liver but later can be found in the pancreas, heart and joints. Excess iron is not expected to deposit in the gastric mucosa. This gastric deposition has been found in association with hemochromatosis, oral iron medications, alcohol abuse, blood transfusions, hepatic cirrhosis and spontaneous portacaval shunt with esophageal varices. The precise mechanism of this iron deposition in gastric epithelial and stromal cells is still not well understood; thus, identification of iron in gastric mucosa raises many questions. On histology, the pattern of deposition is variable, and recognition of the pattern is often useful to choose the appropriate workup for the patient and to diagnose and possibly treat the cause of iron overload. In this article, we have described a well-referenced review of this rare clinical entity with different histological patterns, diagnostic tests and the clinical significance of the different patterns of iron deposition.
authors.affiliation: Department of Gastroenterology and Hepatology, University of Nebraska Medical Center, Omaha, NE, USA.
authors.forename: Jiten P
authors.initials: JP
authors.lastname: Kothadia
authors.affiliation: Icahn School of Medicine at Mount Sinai and Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY, USA.
authors.forename: Rezina
authors.initials: R
authors.lastname: Arju
authors.affiliation: Icahn School of Medicine at Mount Sinai and Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY, USA.
authors.forename: Monica
authors.initials: M
authors.lastname: Kaminski
authors.affiliation: Icahn School of Medicine at Mount Sinai and Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, The Brooklyn Hospital Center, Brooklyn, NY, USA.
authors.forename: Arif
authors.initials: A
authors.lastname: Mahmud
authors.affiliation: Icahn School of Medicine at Mount Sinai and Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, The Brooklyn Hospital Center, Brooklyn, NY, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Chow
authors.affiliation: Icahn School of Medicine at Mount Sinai and Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, The Brooklyn Hospital Center, Brooklyn, NY, USA.
authors.forename: Shah
authors.initials: S
authors.lastname: Giashuddin
keywords: Gastric siderosis; hemochromatosis; iron metabolism; mucosal injury; stomach