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. 1978 Aug 12;119(3):229–236.

Diagnostic efficacy of tests for the detection of iron overload in chronic liver disease.

L S Valberg, C N Ghent, D A Lloyd, J V Frei, M J Chamberlain
PMCID: PMC1818130  PMID: 679127

Abstract

The value of tests for the detection of body iron overload was investigated in 8 aptients with clinically manifest primary hemochromatosis, 12 patients with cirrhosis and iron overload and 20 patients with liver disease and low or normal iron stores. Iron overload was defined as the presence of stainable iron in more than 50% of hepatocytes in a liver biopsy specimen. The percentages of patients with a true-positive (abnormal) or true-negative (normal) result were: serum iron concentration 65%, transferin saturation 85%, serum ferritin concentration 78%, serum ferritin:serum glutamic oxaloacetic transaminase (SGOT) index 78%, percent iron absorption 58%, percent iron absorption in relation to serum ferritin concetration 80% and percent iron absorption in relation to serum ferritin:SGOT index 93%. The calculated predictive value of a normal test result for the exclusion of iron overload in patients with liver disease, a group with an assumed prevalence of iron overload of 10%, was 98% to 99% for transferrin saturation and serum ferritin concentration used alone and 100% for these measures used together; the predictive value of an abnormal result for the diagnosis of iron overload was less than 50% for all of the above measures used alone or in combination. Hence, in patients with an increased serum ferritin concentration or transferrin saturation, or both, determination of the hepatocellular iron content of a specimen from a percutaneous liver biopsy is required for the diagnosis of iron overload.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BOTHWELL T. H., COHEN I., ABRAHAMS O. L., PEROLD S. M. A familial study in idiopathic hemochromatosis. Am J Med. 1959 Nov;27:730–738. doi: 10.1016/0002-9343(59)90189-5. [DOI] [PubMed] [Google Scholar]
  2. Barry M. Liver iron concentration, stainable iron, and total body storage iron. Gut. 1974 May;15(5):411–415. doi: 10.1136/gut.15.5.411. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Clinical grand rounds. Hemochromatosis (iron-storage disease). JAMA. 1974 May 6;228(6):743–752. [PubMed] [Google Scholar]
  4. Crosby W. H., Likhite V. V., O'Brien J. E., Forman D. Serum iron levels in ostensibly normal people. JAMA. 1974 Jan 21;227(3):310–312. [PubMed] [Google Scholar]
  5. Feller E. R., Pont A., Wands J. R., Carter E. A., Foster G., Kourides I. A., Isselbacher K. J. Familial hemochromatosis. Physiologic studies in the precirrhotic stage of the disease. N Engl J Med. 1977 Jun 23;296(25):1422–1426. doi: 10.1056/NEJM197706232962501. [DOI] [PubMed] [Google Scholar]
  6. Halliday J. W., Russo A. M., Cowlishaw J. L., Powell L. W. Serum-ferritin in diagnosis of haemochromatosis. A study of 43 families. Lancet. 1977 Sep 24;2(8039):621–624. doi: 10.1016/s0140-6736(77)92495-3. [DOI] [PubMed] [Google Scholar]
  7. Jacobs A., Miller F., Worwood M., Beamish M. R., Wardrop C. A. Ferritin in the serum of normal subjects and patients with iron deficiency and iron overload. Br Med J. 1972 Oct 28;4(5834):206–208. doi: 10.1136/bmj.4.5834.206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Lipschitz D. A., Cook J. D., Finch C. A. A clinical evaluation of serum ferritin as an index of iron stores. N Engl J Med. 1974 May 30;290(22):1213–1216. doi: 10.1056/NEJM197405302902201. [DOI] [PubMed] [Google Scholar]
  9. Luxton A. W., Walker W. H., Gauldie J., Ali A. M., Pelletier C. A radioimmunoassay for serum ferritin. Clin Chem. 1977;23(4):683–689. [PubMed] [Google Scholar]
  11. Powell L. W., Halliday J. W. Letter: Serum ferritin in hemochromatosis. N Engl J Med. 1976 May 20;294(21):1185–1185. doi: 10.1056/NEJM197605202942122. [DOI] [PubMed] [Google Scholar]
  12. Sorbie J., Valberg L. S., Corbett W. E., Ludwig J. Serum ferritin, cobalt excretion and body iron status. Can Med Assoc J. 1975 May 17;112(10):1173–1178. [PMC free article] [PubMed] [Google Scholar]
  13. Valberg L. S., Sorbie J., Ludwig J., Pelletier O. Serum ferritin and the iron status of Canadians. Can Med Assoc J. 1976 Mar 6;114(5):417–421. [PMC free article] [PubMed] [Google Scholar]
  14. Walters G. O., Jacobs A., Worwood M., Trevett D., Thomson W. Iron absorption in normal subjects and patients with idiopathic haemochromatosis: relationship with serum ferritin concentration. Gut. 1975 Mar;16(3):188–192. doi: 10.1136/gut.16.3.188. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Wands J. R., Rowe J. A., Mezey S. E., Waterbury L. A., Wright J. R., Halliday J. W., Isselbacher K. J., Powell L. W. Normal serum ferritin concentrations in precirrhotic hemochromatosis. N Engl J Med. 1976 Feb 5;294(6):302–305. doi: 10.1056/NEJM197602052940603. [DOI] [PubMed] [Google Scholar]

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