VARIABILITY IN HEPATIC IRON CONCENTRATION MEASUREMENT FROM NEEDLE-BIOPSY SPECIMENS

Background/Aim: Quantitative measurement of hepatic iron by biochemica l analysis of liver biopsy samples is required to assess hepatic iron stores accurately, Cirrhotic livers, however contain variable amounts of fibrous tissue and the distribution of iron within the hepatic pare nchyma is not always uniform, The aim of this study was to assess the variability in hepatic iron concentration measurement from needle-biop sy specimens. Methods: The livers from eight patients with cirrhosis s elected because of elevated serum ferritin were obtained at the time o f liver transplantation (n=6) or at autopsy (n=2), Multiple needle bio psies were done, and hepatic iron concentration was measured by atomic absorption spectroscopy, The hepatic iron index was calculated as iro n concentration divided by age. Results: Four cases had a mean hepatic iron index above 2.0, in the range of that reported in patients with homozygous genetic hemochromatosis, whereas the other four had an hepa tic iron index of less than 2.0, The intra-individual coefficient of v ariation for hepatic iron concentration ranged from 11.3 to 43.7%, ave raging 24.9%, The coefficient of variation was smaller in biopsy sampl es >4 mg dry weight than in samples <4 mg (19.8% vs 28.6%, p<0.05), Hi stological examination of surgical biopsies from these livers showed l arge amounts of fibrous tissue, and inhomogeneous distribution of iron in the hepatic parenchyma. Conclusions: This study demonstrates an im portant variability in the measurement of hepatic iron content from ne edle biopsy specimens in patients with severe cirrhosis.