Synovial iron deposits in black subjects with iron overload

The traditional alcoholic beverages drunk by many South African blacks are prepared in iron drums, and, as a result, iron overload is common in this population. The typical pattern of iron distribution in such persons with severe iron overload is one in which the major deposits are in hepatocytes and the reticuloendothelial system. However, when cirrhosis is present, significant epithelial deposits are found in a number of organs. In the present study, the synovium of the knee joint was examined in 41 black subjects and synovial iron deposits, when present, were correlated with those in other organs. Significant amounts of iron in the synovial-lining cells were not found in any subject in whom the hepatic iron concentration was less than 1% dry weight. Heavy deposits, which were found in six of 19 subjects with concentrations above this figure, only occurred in those exhibiting cirrhosis and significant levels of histological iron in a number of epithelial tissues. Insofar as iron uptake is concerned, these findings suggest that there are cells within the synovium that have the functional characteristics of epithelial cells.