Chronic active hepatitis and hepatic failure in the setting of idiopathic hemochromatosis

We report a case of idiopathic hemochromatosis presenting clinically, biochemically, and histopathologically with features of chronic active hepatitis. Liver biopsy demonstrated excessive iron deposition as well as a striking inflammatory process. Progressive deterioration of hepatic function led to death despite return of iron levels to values seen in phlebotomy-treated patients with idiopathic hemochromatosis. This case suggests that patients with idiopathic hemochromatosis are not immune to other liver disorders and demonstrates the value of serum tissue iron studies in patients with liver disease of uncertain etiology.