Iron Deposits in the Body and Their Pathologic Significance: A Review

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Abstract
Only small amounts of the Fe content of the body can be demonstrated with histochemical methods. They are essentially the loose ferric oxide protein compounds of hemosiderin and ferritin (the storage Fe) and the tissue Fe of the brain, the latter probably deriving from the cellular Fe attached to the cytochrome. Fe absorbed from the intestinal mucosa is transported to the liver and stored in the reticuloendothelial system. Only excess ferritin becomes visible in Fe stains. It is similar to the hemosiderin formed from hemoglobin (Hb) of effused red cells. Localized deposits of hemosiderin indicate a disintegration of Hb and destruction of red cells in injuries or diseases, if found in circumscribed areas of the body within phagocytes. Overloading organs, of the reticuloendothelial system and many glandular structures with Fe occurs under different conditions and can be produced experimentally. Examples of hemosiderosis and hemochromatosis are the endogenous type of hemochromatosis (bronzed diabetes) and the exogenous type by overloading of organs with Fe after numerous transfusions in different forms of anemia. A special role has to be attributed to the brain Fe, which is found as perivascular deposits or vascular incrustations in the globus pallidus and cerebellum, stria turn, and substantia nigra. It is a frequent finding in elderly patients with mental diseases and not typical for special diseases. Exceptions are Hallervorden-Spatz disease and general paresis, where perivascular cortical Fe deposits have diagnostic value. Frequently, in cerebral arteriosclerosis, increased deposits of tissue Fe in the basal ganglia are combined with phagocytic elements containing hemosiderin or hematoidin as a sign of preceding hemorrhages or vascular disturbances. Formation of the blood pigments after hemorrhages occurs faster in animal than in human tissues. Hemosiderin is formed in man after the 5th day, hematoidin after the 11th day; both pigments remain visible in injured and hemorrhagic areas for an indefinite period.

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