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World J Gastroenterol. Sep 21, 2007; 13(35): 4755-4760
Published online Sep 21, 2007. doi: 10.3748/wjg.v13.i35.4755
Pathology of hepatic iron overload
Yves Deugnier, Bruno Turlin
Yves Deugnier, Liver Unit and CIC INSERM 0203, Pontchaillou University Hospital, Rennes 35033, France
Bruno Turlin, Department of Pathology and INSERM U 522, Pontchaillou University Hospital, Rennes 35033, France
Author contributions: All authors contributed equally to the work.
Correspondence to: Yves Deugnier, Professor of Hepatology, Liver Unit and CIC INSERM 0203, Pontchaillou University Hospital, Rennes 35033, France. yves.deugnier@univ-rennes1.fr
Telephone: +33-2-99284297 Fax: +33-2-99284112
Received: March 30, 2007
Revised: May 1, 2007
Accepted: May 9, 2007
Published online: September 21, 2007
Abstract

Although progress in imaging and genetics allow for a noninvasive diagnosis of most cases of genetic iron overload, liver pathology remains often useful (1) to assess prognosis by grading fibrosis and seeking for associated lesions and (2) to guide the etiological diagnosis, especially when no molecular marker is available. Then, the type of liver siderosis (parenchymal, mesenchymal or mixed) and its distribution throughout the lobule and the liver are useful means for suggesting its etiology: HLA-linked hemochromatosis gene (HFE) hemochromatosis or other rare genetic hemochromatosis, nonhemochromatotic genetic iron overload (ferroportin disease, aceruloplasminemia), or iron overload secondary to excessive iron supply, inflammatory syndrome, noncirrhotic chronic liver diseases including dysmetabolic iron overload syndrome, cirrhosis, and blood disorders.

Keywords: Iron; Liver; Biopsy; Hemochromatosis; Ferroportin; HLA-linked hemochromatosis gene; Hepcidin; Metabolic syndrome