Liver Iron and Copper Assessment in Bioptic Material from Patients with Different Hepatic Pathology – Diagnostic Significance and Relationship to Serum Iron and Copper Parameters

Czech version

Authors: M. Dastych ¹; M. Číhalová ³; M. Dastych, jr. ²
Authors‘ workplace: Oddělení klinické biochemie FN Brno a Katedra laboratorních metod LF MU ¹; Interní gastroenterologická klinika FN Brno a LF MU ²; Ústav patologie FN Brno a LF MU ³
Published in: Klin. Biochem. Metab., 22 (43), 2014, No. 4, p. 184-188

Overview

Objective:
The aim of the present work was to evaluate the results of quantitative determination of liver iron and copper content using atomic absorption spectrometry on liver tissue specimens obtained by percutaneous liver biopsy.

Patients:
A cohort of 83 patients was divided into 4 groups according to histological findings: group I (normal histological picture; n = 27), group II (chronic hepatitis; n = 33), group III (cirrhosis; n = 10), group IV (hemochromatosis; n = 10), and 3 cases of Wilson disease.

Results:
As expected, in group IV (hemochromatosis) we detected a significantly increased iron content in the liver tissue (3.73 ± 1.93 mg/g) and concentration of ferritin in the serum (966 ± 560 µg/L); (p < 0.001), along with an increased value of transferrin saturation (0.66 ± 0.20); (p < 0.05) versus group I. A statistically significant Pearson linear correlation was seen between the liver iron and ferritin concentration (r = 0.6573; p < 0.001) and between liver iron and transferrin saturation (r = 0.6878; p < 0.001). The liver copper content in groups I, II and IV did not differ significantly. The group of patients with liver cirrhosis (group III) showed significantly increased values of liver copper (247 ± 161 µg/g) as well as serum copper (24.8 ± 7.2 µmol/L) versus values in group I (52.5 ± 29.4 µg/g and 16.1 ± 5.0 µmol/L) respectively, (p < 0.001). In connection with the finding of increased copper content in group III (cirrhosis), we also observed significantly elevated alkaline phosphatase activity (p < 0.05).

Conclusions:
Out of the iron metabolism serum parameters which show a correlation with liver iron, the highest suitability is exhibited by ferritin and transferrin saturation. The indication for liver tissue copper content determination is an unequivocal part of the diagnostics of Wilson disease. This procedure cannot be replaced by the histochemical proof of copper in a bioptic specimen of liver tissue. However, copper values of around 250 µg/g of dry liver tissue have to be evaluated carefully, and other possible causes have to be taken into consideration.

Keywords:
Iron, copper, liver biopsy, ferritin, transferrin saturation.

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Article was published in

Clinical Biochemistry and Metabolism

2014 Issue 4