Liver
iron concentrations were determined in 60 alcoholics with
liver disease of varying severity, 15 patients with untreated idiopathic
hemochromatosis, and 16 control subjects with
biliary tract disease. Mean liver
iron concentrations (microgram/100 mg dry weight) were significantly greater in the alcoholics (156.4 +/- 7.8 (SEM); P less than 0.05) and in patients with idiopathic
hemochromatosis (2094.5 +/- 230.7; P less than 0.01) than in control subjects (53.0 +/- 7.0). Liver
iron concentrations of greater than 140 micrograms/100 were found in 17 alcoholics (29%) and in all 15 patients with idiopathic
hemochromatosis. Liver
iron concentrations greater than 1000 micrograms/100 mg were found in all patients with idiopathic
hemochromatosis but in none of the alcoholics. In the alcoholics no relationship existed between liver
iron concentrations and the amount of alcohol consumed daily, the length of the drinking history, the amount of beverage
iron consumed daily, or the severity of the
liver disease. Serum
ferritin concentrations reflected
iron stores in patients with
hemochromatosis and in alcoholics with minimal
liver disease. However, in alcoholics with significant
liver disease serum
ferritin concentrations did not reflect
iron stores accurately, although with normal values
iron overload is unlikely. Serum
iron concentration and percentage saturation of total
iron-binding capacity were of little value in assessing
iron status in either alcoholics or patients with
hemochromatosis. Measurement of the liver
iron concentration clearly differentiates between alcoholics with significant
siderosis and patients with idiopathic
hemochromatosis.