Localization of Iron in the Hepatic Acini and in Bile Duct Epithelium as a Tool for Estimation of Liver Iron Overload

Sindram, Jan W.; Marx, Joannes J.M.

doi:10.1111/j.1749-6632.1988.tb55528.x

Cited by 5 publications

(4 citation statements)

References 3 publications

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“…Liver steatosis was graded as mild (less than 30% of a lobule with macrovacuolar steatosis), moderate (30-50%), or severe (>50%). Perl's stain was used for histological evaluation of hepatic iron storage, to assess the pattern of the deposit (hepatocellular of Kupffer cell) and the severity (histological grade) (18). Presence and severity of cholestasis were also recorded when present.…”

Section: Methodsmentioning

confidence: 99%

Factors Influencing the Rate of Fibrosis Progression in Chronic Hepatitis C

et al. 2004

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Alcohol consumption, age at infection, and male gender have been identified as risk factors for faster fibrosis progression in patients with chronic hepatitis C (CHC). Yet the influence of liver steatosis, light to moderate alcohol consumption, or iron overload on this progression remains controversial. To analyze the effect of individual risk factors and their interaction on fibrosis progression in a group of patients with CHC and a definite date of infection, we studied 133 consecutive untreated patients. Covariates included were age, body mass index (BMI), gender, age at infection, alcohol intake, serum lipids, glycemia, serum ALT, AST, GGT, iron, and ferritin, grade and stage (METAVIR and Scheuer), and hepatic stainable iron (Perl's stain). The rate of fibrosis progression was inferred from the METAVIR score. By logistic regression analysis, hepatic steatosis (odds ratio [OR], 3.035; 95% confidence interval [CI], 1.16-7.93), serum ferritin levels higher than 290 ng/ml (OR, 5.5; 1.6-18.65), and light to moderate ethanol intake (1-50 g/day) (OR, 5.22; 1.5-17.67) were independently associated with faster fibrosis progression. There was no effect of interaction between these variables on the rate of fibrosis progression. Liver steatosis, serum ferritin levels, and light to moderate alcohol intake are associated with faster fibrosis progression in chronic hepatitis C. Combination of these factors did not further accelerate this progression. The impact of modification of these factors on progression should be tested in longitudinal studies.

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Section: Methodsmentioning

confidence: 99%

Factors Influencing the Rate of Fibrosis Progression in Chronic Hepatitis C

et al. 2004

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“…26 Since then, several methods have been proposed. The simplest are based on percent of hepatocytes 41 or zonal involvement, 80 reflecting the concept of the gradient of hepatocellular deposition, but notably focused only on hepatocellular iron deposition. The most commonly used system takes into account ease of detection of granules 81,82 but does not distinguish cell type.…”

Section: Semiquantitative Grading Of Iron By Light Microscopymentioning

confidence: 99%

Pathology of Hepatic Iron Overload

Brunt¹

2005

Semin Liver Dis

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The role of liver biopsy in all chronic liver diseases continues to evolve with the emergence of new laboratory and imaging tests. However, the value of histologic examination for fibrosis, parenchymal architectural remodeling, and possible concurrent disease remains relatively unchallenged, including in patients with suspected iron overload. In addition, only histologic evaluation allows detailed analysis of cellular and acinar localization of iron. Routine use of an iron stain for all liver biopsy analysis enables detection of iron when not otherwise suspected. The broad classifications of iron overload include parenchymal ("primary") or reticuloendothelial ("secondary"), and mixed. These classifications, however, serve only as guidelines to differential diagnoses, as will be noted in the following review of pathology of iron overload. Ultimately, the role of the pathologist is to document cellular and acinar localization of iron and to provide a semiquantitative assessment of amount to alert the clinician to the possibility of a significant condition. In this article, histopathologic findings in conditions of iron overload and in several forms of liver disease are discussed.

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“…Masses visible at ×10, or naked eye Table 2 Histological grading of iron storage from Sindram and Marx (1988).…”

Section: Gradementioning

confidence: 99%

“…The Scheuer's scoring system, either in its original presentation (Scheuer et al, 1962) or modified according to Rowe et al (1977) (Table 1) and Sindram and Marx (1988) (Table 2) is widely used because it is simple. However, it was not satisfactorily validated.…”

Section: Introductionmentioning

confidence: 99%