SERUM PROCOLLAGEN-III PEPTIDE CONCENTRATION IN IRON OVERLOAD

Patients with severe iron overload may develop hepatic fibrosis due to iron toxicity. Unfortunately, the follow-up of the fibrogenic activit y during treatment by histological examination of tissue biopsies carr ies potential side effects, and may therefore not be justified ethical ly. Recently, the serum concentration of procollagen type III peptide (S-PIIINP) has been shown to be a valid serum marker of the activity o f collagen metabolism in conditions with hepatic fibrosis unrelated to iron overload. In order to evaluate the potential usefulness of this test in patients with fibrosis due to iron overload, we investigated t he relationship between the PIIINP serum concentration and the size of iron overload in 18 patients with hereditary haemochromatosis (HH) an d in 14 patients with transfusional iron overload. A close correlation was found between S-ferritin and S-PIIINP (r=0.73, p<0.0001). Follow- up of 6 patients during iron depletion treatment revealed a normalizat ion of the serum aminotransferase concentration before normalization o f S-PIIINP was found. This may indicate that excess iron directly indu ces an increase in fibrogenesis rather than the increased fibrogenesis is secondary to hepatocellular injury caused by iron excess. Thus, se rial measurements S-PIIINP may be useful in follow-up of the fibrogeni c process due to iron overload.