AN EVALUATION OF THE SERUM IRON IN LIVER DISEASE

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Abstract
The internal redistribution of Fe in the body occurs through the serum Fe compartment with the liver playing an important role. Reported studies of serum Fe in liver disease have shown that in general it is normal in patients with cirrhosis with or without jaundice and in patients with extrahepatic biliary obstruction. In acute hepatitis the serum Fe is elevated, this being the only acute infectious disease known to cause such a change. This study reports 61 patients with liver disease proven by histological examination in whom 147 determinations of serum Fe were made. Twenty-five normal subjects were studied, giving a serum Fe range of 70-170 [mu]g% and a mean of 108.4 [mu]g%. Thirty-four patients with cirrhosis showed a mean of 102 [mu]g%. Ten patients with obstructive jaundice showed a mean of 116 [mu]g% and 17 patients with hepatitis had a mean of 240 [mu]g. Serum Fe determination was carried out by a modification of the method described by Barkin and Walker. No correlation was noted when the serum Fe results were plotted against any of the commonly used liver function tests. Elevations of serum Fe in hepatitis were felt to be due to hepatic cell necrosis with release of Fe back to the serum compartment. Two case histories, one from a patient with a prolonged convalescence from hepatitis and one patient with an average course of hepatitis, were recorded charting the serial determination of serum Fe and other liver function tests. It was concluded that serum Fe is helpful in the differential diagnosis of jaundice and should replace less specific tests and that the late appearance of a maximal rise in the serum Fe level in acute hepatitis suggests a more prolonged course.