Kv. Kowdley et al., UTILITY OF HEPATIC IRON INDEX IN AMERICAN PATIENTS WITH HEREDITARY HEMOCHROMATOSIS - A MULTICENTER STUDY, Gastroenterology, 113(4), 1997, pp. 1270-1277
Background & Aims: A hepatic iron index (hepatic iron concentration di
vided by age) of move than 1.9 has been proposed as useful to identify
patients with homozygous hereditary hemochromatosis (HHC). There are
limited data on the diagnostic use of the hepatic iron index in patien
ts with HHC in the United States, This study evaluated the hepatic iro
n index in the diagnosis of HHC in a multicenter U.S. study. Methods:
Hepatic iron concentration was measured in 509 patients undergoing liv
er biopsy, The diagnosis of HHC was made using clinical, biochemical,
and histopathologic criteria. Results: Fifty-five patients met criteri
a for HHC; hepatic iron index was >1.9 in 51 of 55 (93%) patients with
HHC but in none of 454 patients with other liver diseases; hepatic ir
on concentration was >71 mu mol/g dry weight in 54 of 55 patients with
HHC but only 1 of the other 454 patients. Conclusions: A hepatic iron
index of greater than or equal to 1.9 can identify most U.S. patients
with HHC but is less than or equal to 1.9 in 7%. A ''threshold'' hepa
tic iron concentration of 71 mu mol/g can almost always distinguish pa
tients with HHC from patients with other liver diseases and may be a u
seful adjunct to the hepatic iron index in the diagnosis of HHC in the
diverse U.S. population.