Liver damage in disorders of iron overload. A hypothesis

The pathogenesis of liver damage in patients with iron loading disorders is not explained. Evidence concerning the following hypothesis is reviewed: Iron, absorbed from the intestinal tract when transferrin saturation is complete or almost so, remains unbound and is lost into the liver on first passage through the portal circulation. By still-to-be-determined molecular events, unbound iron is toxic to liver cells and produces progressive damage when this process occurs repeatedly.