Hepatic and serum ferritin concentrations in patients with idiopathic hemochromatosis

Hepatic iron and ferritin concentrations have been measured in needle biopsy specimens from patients with idiopathic hemochromatosis and from patients with other liver diseases. There was an excellent correlation between liver iron and ferritin concentrations in patients with miscellaneous liver diseases, but this was not found for the patients with hemochromatosis either before or after treatment. The proportion of liver iron bound to ferritin was lower in treated and untreated hemochromatosis than in the other patients. This probably reflects the formation of increasing amounts of hemosiderin with increasing iron deposition. Three patients in the early stage of idiopathic hemochromatosis were studied. These patients had high concentrations of hepatic iron and ferritin, but had serum ferritin concentrations within, or just above, the normal stage. These results suggest that, in the early stage of hemochromatosis, there is no failure of ferritin synthesis in the liver and that normal levels of serum ferritin are present either because the total body iron content is within the normal range or because the liver parenchymal cells are not, in the absence of liver damage, an important source of plasma ferritin.