Iron overload secondary to cirrhosis: a mimic of hereditary haemochromatosis?

Area of Science:

• Hepatology
• Gastroenterology
• Pathology

Background:

• Hepatic iron deposition is common in cirrhosis, often unrelated to hereditary hemochromatosis.
• The extent of extrahepatic iron deposition in cirrhosis is not well-characterized.

Purpose of the Study:

• To investigate the association between hepatic iron deposition and extrahepatic organ iron deposition in cirrhosis patients.
• To determine if cirrhosis-related hepatic haemosiderosis correlates with iron accumulation in organs beyond the liver.

Main Methods:

• Autopsy records of 104 adult cirrhosis patients were reviewed.
• Histochemical staining assessed storage iron in the liver, heart, pancreas, and spleen.
• HFE genotyping was performed on individuals with significant iron deposition.

Main Results:

• 46% of patients had stainable hepatic iron; most cases were mild (2+ or less).
• Six patients (approx. 6%) exhibited heavy hepatic iron deposition (4+).
• These six patients also had pancreatic iron, and five had cardiac iron, without HFE gene mutations.

Conclusions:

• Heavy hepatic iron deposition in cirrhosis is frequently linked to pancreatic and cardiac iron.
• This iron deposition pattern resembles hemochromatosis, despite a lack of HFE mutations.
• Cirrhosis patients with significant hepatic haemosiderosis may face risks of extrahepatic iron overload complications.