Patients with Chronic Hepatitis C May be More Sensitive to Iron Hepatotoxicity than Patients with HFE-Hemochromatosis

• Hayashi Hisao

  Department of Medicine, Aichi Gakuin University School of Pharmacy

• Piperno Alberto

  Department of Clinical Medicine and Prevention, University of Milano-Bicocca

• Tomosugi Naohisa

  Division of Nephrology, Department of Internal Medicine, Kanazawa Medical University

• Hayashi Kazuhiko

  Divison of Gastroenterology, Department of Internal Medicine, Nagoya University School of Medicine

• Kimura Fumiaki

  Department of Internal Medicine, Tamano Municipal Hospital

• Wakusawa Shinya

  Department of Medical Technology, Nagoya University School of Health Sciences

• Yano Motoyoshi

  Department of Medicine, Yokkaichi City Hospital

• Tatsumi Yasuaki

  Department of Medicine, Aichi Gakuin University School of Pharmacy

• Hattori Ai

  Department of Medicine, Aichi Gakuin University School of Pharmacy

• Pelucchi Sara

  Department of Clinical Medicine and Prevention, University of Milano-Bicocca

• Katano Yoshiaki

  Divison of Gastroenterology, Department of Internal Medicine, Nagoya University School of Medicine

• Goto Hidemi

  Divison of Gastroenterology, Department of Internal Medicine, Nagoya University School of Medicine

抄録

Aim In chronic hepatitis C, iron might play an important role as a hepatotoxic co-factor. Therefore, venesection, a standard treatment for hemochromatosis, has been proposed as an alternative for patients who respond poorly to anti-viral therapy. To improve our understanding of iron-induced hepatotoxicity, we compared the responses to venesection between patients with chronic hepatitis C and those with HFE-hemochromatosis.<br> Methods Fourteen Japanese patients with chronic hepatitis C and eight Italian patients with HFE-hemochromatosis underwent repeated venesection with a serum ferritin endpoint of 20 and 50 ng/mL, respectively. Serum iron indices and liver function tests were measured in pre- and post treatment blood samples from each patient. Body iron stores were calculated using the removed blood volume.<br> Results In both patients with hepatitis and hemochromatosis, serum ferritin, aminotransferase and hepcidin 25 were reduced after venesection. The serum aminotransferase activity, but not the serum ferritin level, was predictive of effective iron removal treatment. Hepcidin regulation was set at an inappropriately low level in hemochromatosis patients (11.1 ± 9.2 ng/mL), but not so in hepatitis patients (30.7 ± 14.5 ng/mL). Inversely, the estimated body iron stores of hemochromatosis patients were 5,960 ± 2,750 mg, while those of hepatitis patients were 730 ± 560 mg. Judging from the liver enzyme reduction ratio, patients with hepatitis seemed to be more sensitive to iron hepatotoxicity than hemochromatosis patients.<br> Conclusion Even though the threshold of iron hepatotoxicity and benefit of its removal differ between patients with chronic hepatitis C and those with HFE-hemochromatosis, venesection is a valid choice of treatment to reduce liver disease activity in both diseases.<br>

収録刊行物

• Internal Medicine

  Internal Medicine 49 (22), 2371-2377, 2010

  一般社団法人 日本内科学会

キーワード

• body iron store
• hemochromatosis
• HFE
• hepatitis C
• hepcidin
• venesection

詳細情報

• CRID: 1390001204872717952
• NII論文ID: 130000413363
• DOI: 10.2169/internalmedicine.49.4088
• ISSN: 13497235
• ISSN: 09182918
• Web Site: http://www.jstage.jst.go.jp/article/internalmedicine/49/22/49_22_2371/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2011177157
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • CiNii Articles
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