Abstract
The accumulation of iron plays a role in the pathogenesis of chronic hepatitis C. Therefore, even slight excesses of iron should be measured if possible. Eight patients were entered in this study who were negative for histochemical tests for iron in the liver. X-ray microanalysis showed that all eight patients had iron stored as scattered hepatocyte hemosiderin. Hemosiderin iron index expressed as the Fe X-ray count was correlated with serum ferritin levels. Phlebotomy reduced serum aminotransferase levels. Thus, the serum ferritin level is an index of excess iron that potentiates viral-induced hepatotoxicity in chronic hepatitis C.
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Kato J, Kobune M, Kohgo Y, Sugawara N, Hisai H, Nakamura T, Sakamaki S, Sawada N, Niitsu Y (1996) Hepatic iron deprevation prevents spontaneous development of fulminant hepatitis and liver cancer in LEC rats. J Clin Invest 98:923–929
Piperno A, D'Alba R, Roffi L, Pozzi M, Farina A, Vecchi L, Fiorelli G (1992) Hepatitis C virus infection in patients with idiopathic hemochromatosis (IH) and porphyria cutanea tarda (PCT). Arch Virol 4 (suppl):215–216
Di Bisceglie AM, Axiotis CA, Hoofnagle JH, Bacon BR (1992) Measurements of iron status in patients with chronic hepatitis. Gastroenterology 102:2108–2113
Kato S, Arao M, Kuriki J, Tagaya T, Takiya S, Kato K, Takikawa T, Hayashi H (1994) Biochemical improvement of chronic hepatitis C after gastrointestinal bleeding. Nagoya J Med Sci 57:153–157
Piperno A, Roffi L, Pozzi M, D'Alba R, Fargion S, Mandelli M, Failla M, Fiorelli G (1992) Can iron depletion therapy ameliorate hepatocellular injury in anti-HCV-positive chronic hepatitis? (abstract). Gastroenterology 102:A868
Hayashi H, Takikawa T, Nishimura N, Yano M (1992) Intense phlebotomy as a potential means to normalize AST and ALT in chronic active hepatitis C (abstract). Hepatology 16:204A
Hayashi H, Takikawa T, Nishimura N, Yano M, Isomura T, Sakamoto N (1994) Improvement of serum aminotransferase levels after phlebotomy in patients with chronic active hepatitis C and excess hepatic iron. Am J Gastroenterol 89:986–988
Bacon BR, Rebholz AE, Fried M, Di Bisceglic AM (1993) Beneficial effect of iron reduction therapy in patients with chronic hepatitis C who failed to respond to interferon-α (abstract). Hepatology 18:150A
Han S-H, Fong T-L, Valinluck B, Adkins RH, Redeker AG (1995) Randomized controlled trial of the effect of iron depletion on aminotransferase levels, HCV RNA and response to interferon therapy in patients with chronic hepatitis C virus (abstract). Hepatology 22:180A
Desai TK (1995) Phlebotomy reduces transaminase levels without inducing iron deficiency in patients with chronic hepatitis C (abstract). Hepatology 22:408A
Hayashi H, Takikawa T, Nishimura N, Yano M (1995) Serum aminotransferase levels as an indicator of the effectiveness of venesection for chronic hepatitis C. J Hepatol 22:268–271
Farinati F, Cardin R, De Maria N, Della Libera G, Marafin C, Lecis E, Burra P, Floreani A, Cecchetto A, Naccarato R (1995) Iron storage, lipid peroxidation and glutathione turnover in chronic anti-HCV positive hepatitis. J Hepatol 22:449–456
Okamoto H, Sugiyama Y, Okada S, Kurai K, Akahane Y, Sugai Y, Tanaka T, Sato K, Tsuda F, Miyakawa Y, Mayumi M (1992) Typing hepatitis C virus by polymerase chain reaction with typespecific primers: application to clinical surveys and tracing infections sources. J Gen Virol 73:673–679
Bresters D, Cuypers HTM, Reesink HW, Mauser-Bunschoten EP, van den Berg HM, Schaasberg WP, Wilber JC, Urdea MS, Neuwald P, Lelie PN (1994) Comparison of quantitative cDNA-PCR with the branched DNA hybridization assay for monitoring plasma hepatitis C virus RNA levels in haemophilia patients participating in a controlled interferon trial. J Med Virol 43:262–268
Olynyk JK, O'Neill R, Britton RS, Bacon BR (1994) Determination of hepatic iron concentration in fresh and paraffin-embedded tissue: diagnostic implications. Gastroenterology 106:674–677
Hanaichi T, Kidokoro R, Hayashi H, Sakamoto N (1984) Electron probe X-ray analysis on human hepatocellular lysosomes with copper deposits: copper binding to a thiol-protein in lysosomes. Lab Invest 51:592–597
Prieto J, Barry M, Sherlock S (1975) Serum ferritin in patients with iron overload and with acute and chronic liver disease. Gastroenterology 68:525–533
Hayashi H, Yagi A, Sasa A, Ohguchi S, Sakamoto N, Hanaichi T (1986) Elemental analysis of the in situ hepatocellular hemosiderin of a patient with idiopathic hemochromatosis. J Clin Electron Microsc 19:321–326
Jacobs A, Miller F, Worwood M, Beamish MR, Wardrop CA (1972) Ferritin in the serum of normal subjects and patients with iron deficiency and iron overload. Br Med J 4:206–208
Ozaki M, Kawabata T, Awai M (1972) Iron release from haemosiderin and production of iron-catalysed hydroxyl radicals in vitro. Biochem J 250:589–595
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Yano, M., Hayashi, H., Wakusawa, S. et al. Hepatotoxic iron storage in patients with chronic hepatitis C but no hepatic iron detectable histochemically. Med Electron Microsc 30, 70–75 (1997). https://doi.org/10.1007/BF01545084
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DOI: https://doi.org/10.1007/BF01545084