In the present study, cirrhosis of the liver was found in one of six cases of transfusional siderosis. The relationship between iron overload and cirrhosis is discussed and the suggestion is made that factors other than iron deposition may have been responsible for the hepatic fibrosis. Three patients with a greater degree of iron overload, and for a longer period, did not develop fibrosis or cirrhosis. The possibility remains that iron absorbed from the gut and stored in excess without having passed through the haemoglobin molecule or the reticuloendothelial system may be toxic, as cases have been reported in which cirrhosis of the liver was attributed to prolonged iron medication.
The cirrhosis in idiopathic haemochromatosis may be due to lack of an unknown hepatic cell enzyme, as in galactosaemia, and the increased iron absorption may be a concomitant finding. Transfusional or secondary haemochromatosis is not a definite entity, and the liver cirrhosis is probably due to causes other than the excess deposition of haemosiderin.
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