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Iron overload secondary to cirrhosis: a mimic of hereditary haemochromatosis?
Aims Hepatic iron deposition unrelated to hereditary haemochromatosis is common in cirrhosis. The aim of this study was to determine whether hepatic haemosiderosis secondary to cirrhosis is associated with iron deposition in extrahepatic organs. Methods and results Records of consecutive adult patie...
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| Published in: | Histopathology 2014-10, Vol.65 (4), p.561-569 |
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| Main Authors: | , , , |
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| Language: | English |
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| cites | cdi_FETCH-LOGICAL-c4617-1833450d95fc176289b307f3e3f004dfa99137193e0d358b2ec6f88c0ea2f7b73 |
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| container_title | Histopathology |
| container_volume | 65 |
| creator | Abu Rajab, Murad Guerin, Leana Lee, Pauline Brown, Kyle E |
| description | Aims
Hepatic iron deposition unrelated to hereditary haemochromatosis is common in cirrhosis. The aim of this study was to determine whether hepatic haemosiderosis secondary to cirrhosis is associated with iron deposition in extrahepatic organs.
Methods and results
Records of consecutive adult patients with cirrhosis who underwent autopsy were reviewed. Storage iron was assessed by histochemical staining of sections of liver, heart, pancreas and spleen. HFE genotyping was performed on subjects with significant liver, cardiac and/or pancreatic iron. The 104 individuals were predominantly male (63%), with a mean age of 55 years. About half (46%) had stainable hepatocyte iron, 2+ or less in most cases. In six subjects, there was heavy iron deposition (4+) in hepatocytes and biliary epithelium. All six of these cases had pancreatic iron and five also had cardiac iron. None of these subjects had an explanatory HFE genotype.
Conclusions
In this series, heavy hepatocyte iron deposition secondary to cirrhosis was commonly associated with pancreatic and cardiac iron. Although this phenomenon appears to be relatively uncommon, the resulting pattern of iron deposition is similar to haemochromatosis. Patients with marked hepatic haemosiderosis secondary to cirrhosis may be at risk of developing extrahepatic complications of iron overload. |
| doi_str_mv | 10.1111/his.12417 |
| format | article |
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Hepatic iron deposition unrelated to hereditary haemochromatosis is common in cirrhosis. The aim of this study was to determine whether hepatic haemosiderosis secondary to cirrhosis is associated with iron deposition in extrahepatic organs.
Methods and results
Records of consecutive adult patients with cirrhosis who underwent autopsy were reviewed. Storage iron was assessed by histochemical staining of sections of liver, heart, pancreas and spleen. HFE genotyping was performed on subjects with significant liver, cardiac and/or pancreatic iron. The 104 individuals were predominantly male (63%), with a mean age of 55 years. About half (46%) had stainable hepatocyte iron, 2+ or less in most cases. In six subjects, there was heavy iron deposition (4+) in hepatocytes and biliary epithelium. All six of these cases had pancreatic iron and five also had cardiac iron. None of these subjects had an explanatory HFE genotype.
Conclusions
In this series, heavy hepatocyte iron deposition secondary to cirrhosis was commonly associated with pancreatic and cardiac iron. Although this phenomenon appears to be relatively uncommon, the resulting pattern of iron deposition is similar to haemochromatosis. Patients with marked hepatic haemosiderosis secondary to cirrhosis may be at risk of developing extrahepatic complications of iron overload.</description><identifier>ISSN: 0309-0167</identifier><identifier>EISSN: 1365-2559</identifier><identifier>DOI: 10.1111/his.12417</identifier><identifier>PMID: 24635122</identifier><identifier>CODEN: HISTDD</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adult ; Aged ; Aged, 80 and over ; cardiomyopathy ; Coloring Agents ; Female ; Ferrocyanides ; Genotype ; haemosiderosis ; Hemochromatosis - pathology ; Hemochromatosis Protein ; hepcidin ; HFE ; Histocompatibility Antigens Class I - genetics ; Humans ; Iron Overload - etiology ; Iron Overload - pathology ; Liver Cirrhosis - complications ; Male ; Membrane Proteins - genetics ; Middle Aged ; Mutation ; pancreas</subject><ispartof>Histopathology, 2014-10, Vol.65 (4), p.561-569</ispartof><rights>2014 John Wiley & Sons Ltd</rights><rights>2014 John Wiley & Sons Ltd.</rights><rights>Copyright © 2014 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4617-1833450d95fc176289b307f3e3f004dfa99137193e0d358b2ec6f88c0ea2f7b73</citedby><cites>FETCH-LOGICAL-c4617-1833450d95fc176289b307f3e3f004dfa99137193e0d358b2ec6f88c0ea2f7b73</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24635122$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abu Rajab, Murad</creatorcontrib><creatorcontrib>Guerin, Leana</creatorcontrib><creatorcontrib>Lee, Pauline</creatorcontrib><creatorcontrib>Brown, Kyle E</creatorcontrib><title>Iron overload secondary to cirrhosis: a mimic of hereditary haemochromatosis?</title><title>Histopathology</title><addtitle>Histopathology</addtitle><description>Aims
Hepatic iron deposition unrelated to hereditary haemochromatosis is common in cirrhosis. The aim of this study was to determine whether hepatic haemosiderosis secondary to cirrhosis is associated with iron deposition in extrahepatic organs.
Methods and results
Records of consecutive adult patients with cirrhosis who underwent autopsy were reviewed. Storage iron was assessed by histochemical staining of sections of liver, heart, pancreas and spleen. HFE genotyping was performed on subjects with significant liver, cardiac and/or pancreatic iron. The 104 individuals were predominantly male (63%), with a mean age of 55 years. About half (46%) had stainable hepatocyte iron, 2+ or less in most cases. In six subjects, there was heavy iron deposition (4+) in hepatocytes and biliary epithelium. All six of these cases had pancreatic iron and five also had cardiac iron. None of these subjects had an explanatory HFE genotype.
Conclusions
In this series, heavy hepatocyte iron deposition secondary to cirrhosis was commonly associated with pancreatic and cardiac iron. Although this phenomenon appears to be relatively uncommon, the resulting pattern of iron deposition is similar to haemochromatosis. Patients with marked hepatic haemosiderosis secondary to cirrhosis may be at risk of developing extrahepatic complications of iron overload.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>cardiomyopathy</subject><subject>Coloring Agents</subject><subject>Female</subject><subject>Ferrocyanides</subject><subject>Genotype</subject><subject>haemosiderosis</subject><subject>Hemochromatosis - pathology</subject><subject>Hemochromatosis Protein</subject><subject>hepcidin</subject><subject>HFE</subject><subject>Histocompatibility Antigens Class I - genetics</subject><subject>Humans</subject><subject>Iron Overload - etiology</subject><subject>Iron Overload - pathology</subject><subject>Liver Cirrhosis - complications</subject><subject>Male</subject><subject>Membrane Proteins - genetics</subject><subject>Middle Aged</subject><subject>Mutation</subject><subject>pancreas</subject><issn>0309-0167</issn><issn>1365-2559</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><recordid>eNp10M9PFDEUB_DGYGRZPfAPmEm4yGGWvnbaTr0QQvixETFGBeKl6XZeM8WZLbazKP-9sy5wMLGXd_m8b16_hOwCncH4DtqQZ8AqUC_IBLgUJRNCb5EJ5VSXFKTaJjs531IKijP2imyzSnIBjE3Ix3mKyyLeY-qibYqMLi4bmx6KIRYupNTGHPL7whZ96IMroi9aTNiEYW1ai310bYq9Hdbu8DV56W2X8c3jnJJvpydfj8_Li09n8-Oji9JVElQJNeeVoI0W3oGSrNYLTpXnyD2lVeOt1sAVaI604aJeMHTS17WjaJlXC8Wn5N0m9y7FnyvMg-lDdth1dolxlQ1IEEzUVOmR7v1Db-MqLcfr1qpiVa1Ajmp_o1yKOSf05i6FfvyjAWrWHZuxY_O349G-fUxcLXpsnuVTqSM42IBfocOH_yeZ8_mXp8hysxHygL-fN2z6YaTiSpjryzNzc_n99MMV1eYz_wOud5N8</recordid><startdate>201410</startdate><enddate>201410</enddate><creator>Abu Rajab, Murad</creator><creator>Guerin, Leana</creator><creator>Lee, Pauline</creator><creator>Brown, Kyle E</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope></search><sort><creationdate>201410</creationdate><title>Iron overload secondary to cirrhosis: a mimic of hereditary haemochromatosis?</title><author>Abu Rajab, Murad ; Guerin, Leana ; Lee, Pauline ; Brown, Kyle E</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4617-1833450d95fc176289b307f3e3f004dfa99137193e0d358b2ec6f88c0ea2f7b73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>cardiomyopathy</topic><topic>Coloring Agents</topic><topic>Female</topic><topic>Ferrocyanides</topic><topic>Genotype</topic><topic>haemosiderosis</topic><topic>Hemochromatosis - pathology</topic><topic>Hemochromatosis Protein</topic><topic>hepcidin</topic><topic>HFE</topic><topic>Histocompatibility Antigens Class I - genetics</topic><topic>Humans</topic><topic>Iron Overload - etiology</topic><topic>Iron Overload - pathology</topic><topic>Liver Cirrhosis - complications</topic><topic>Male</topic><topic>Membrane Proteins - genetics</topic><topic>Middle Aged</topic><topic>Mutation</topic><topic>pancreas</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abu Rajab, Murad</creatorcontrib><creatorcontrib>Guerin, Leana</creatorcontrib><creatorcontrib>Lee, Pauline</creatorcontrib><creatorcontrib>Brown, Kyle E</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Histopathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abu Rajab, Murad</au><au>Guerin, Leana</au><au>Lee, Pauline</au><au>Brown, Kyle E</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Iron overload secondary to cirrhosis: a mimic of hereditary haemochromatosis?</atitle><jtitle>Histopathology</jtitle><addtitle>Histopathology</addtitle><date>2014-10</date><risdate>2014</risdate><volume>65</volume><issue>4</issue><spage>561</spage><epage>569</epage><pages>561-569</pages><issn>0309-0167</issn><eissn>1365-2559</eissn><coden>HISTDD</coden><abstract>Aims
Hepatic iron deposition unrelated to hereditary haemochromatosis is common in cirrhosis. The aim of this study was to determine whether hepatic haemosiderosis secondary to cirrhosis is associated with iron deposition in extrahepatic organs.
Methods and results
Records of consecutive adult patients with cirrhosis who underwent autopsy were reviewed. Storage iron was assessed by histochemical staining of sections of liver, heart, pancreas and spleen. HFE genotyping was performed on subjects with significant liver, cardiac and/or pancreatic iron. The 104 individuals were predominantly male (63%), with a mean age of 55 years. About half (46%) had stainable hepatocyte iron, 2+ or less in most cases. In six subjects, there was heavy iron deposition (4+) in hepatocytes and biliary epithelium. All six of these cases had pancreatic iron and five also had cardiac iron. None of these subjects had an explanatory HFE genotype.
Conclusions
In this series, heavy hepatocyte iron deposition secondary to cirrhosis was commonly associated with pancreatic and cardiac iron. Although this phenomenon appears to be relatively uncommon, the resulting pattern of iron deposition is similar to haemochromatosis. Patients with marked hepatic haemosiderosis secondary to cirrhosis may be at risk of developing extrahepatic complications of iron overload.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>24635122</pmid><doi>10.1111/his.12417</doi><tpages>9</tpages></addata></record> |
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| ispartof | Histopathology, 2014-10, Vol.65 (4), p.561-569 |
| issn | 0309-0167 1365-2559 |
| language | eng |
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| source | Wiley-Blackwell Read & Publish Collection |
| subjects | Adult Aged Aged, 80 and over cardiomyopathy Coloring Agents Female Ferrocyanides Genotype haemosiderosis Hemochromatosis - pathology Hemochromatosis Protein hepcidin HFE Histocompatibility Antigens Class I - genetics Humans Iron Overload - etiology Iron Overload - pathology Liver Cirrhosis - complications Male Membrane Proteins - genetics Middle Aged Mutation pancreas |
| title | Iron overload secondary to cirrhosis: a mimic of hereditary haemochromatosis? |
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