Siderosis in the South African Bantu

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Abstract
Post-mortem examinations have shown that siderosis is a common finding in adult Bantu subjects, particularly males in the fourth and fifth decades of life. The deposition of iron occurs mainly in the liver and reticulo-endothelial system. In a small proportion of cases the siderosis is of a severe degree and may be associated with portal fibrosis or cirrhosis. The present radiological investigation has shown that a marked increase in density of the liver and spleen may be observed in Bantu patients with severe siderosis. Liver biopsy studies have demonstrated that these radiological changes are undoubtedly due to the excessive iron deposits in the liver and spleen. Moreover, in a fairly large proportion of patients with radiologically demonstrable hepatic and splenic siderosis (12 out of 21 cases in the present series) evidence of osteoporosis of the spine with collapse of vertebral bodies, especially in the lumbar region, was noted. Although a definite relationship between Bantu siderosis and osteoporosis of bone with vertebral collapse is as yet unproven, it is suggested that the radiological findings in the present series of cases indicate the need for a careful re-assessment of this problem. Furthermore, the radiological observations in these patients have suggested that the 3rd and/or 4th lumbar vertebral bodies would provide the most suitable material for any pathological study which may be undertaken to investigate the possibility of a direct relationship between vertebral siderosis and osteoporosis. Alternative factors which may have been responsible for the vertebral changes are briefly discussed.

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