Hemosiderosis is associated with accelerated decompensation and decreased survival in patients with cirrhosis

Zeid Kayali; Rostislav Ranguelov; Frank Mitros; Chrisandra Shufelt; Farshad Elmi; Stephen C Rayhill; Warren N Schmidt; Kyle E Brown

doi:10.1111/j.1478-3231.2005.01022.x

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Hemosiderosis is associated with accelerated decompensation and decreased survival in patients with cirrhosis

Journal article

Peer reviewed

Hemosiderosis is associated with accelerated decompensation and decreased survival in patients with cirrhosis

Zeid Kayali, Rostislav Ranguelov, Frank Mitros, Chrisandra Shufelt, Farshad Elmi, Stephen C Rayhill, Warren N Schmidt and Kyle E Brown

Liver international, Vol.25(1), pp.41-48

02/2005

DOI: 10.1111/j.1478-3231.2005.01022.x

PMID: 15698397

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Abstract

Although hepatic iron deposition unrelated to hereditary hemochromatosis is commonly observed in cirrhosis, its clinical significance is unclear. The aim of this study was to examine the outcomes of cirrhotic patients with and without hemosiderosis. Patients with an initial liver biopsy demonstrating cirrhosis between January 1993 and December 1997 were identified using the Department of Pathology database. Based on iron staining, patients were characterized as siderotic or nonsiderotic. Charts were reviewed to determine outcomes. Siderotic patients had significantly higher Child-Pugh (CP) and model for end-stage liver disease (MELD) scores. Their median survival without transplant was 23 months vs. 85 months in the nonsiderotics (P<0.0001, confidence interval: 95%). On univariate analysis, siderosis was associated with a hazard ratio of 2.74 (P<0.0001). On multivariate analysis, the effect of siderosis was reduced but remained significant after correction for the CP or MELD score (hazard ratios 1.82 and 2.06, P=0.05 and 0.02, respectively). Child's A cirrhotics with hemosiderosis decompensated more rapidly and had shorter median survival than those without siderosis (P=0.007 and P=0.01, respectively). The presence of siderosis is associated with more advanced liver dysfunction. Even when the effects of baseline liver function are taken into account, siderosis is associated with decreased survival and more rapid decompensation in cirrhosis.

Liver Failure - etiology

Liver Function Tests

Severity of Illness Index

Liver Failure - mortality

Liver Cirrhosis - complications

Humans

Middle Aged

Liver Cirrhosis - mortality

Liver Failure - pathology

Male

Survival Rate

Hemosiderosis - pathology

Iron - metabolism

Hemosiderosis - mortality

Staining and Labeling

Liver Cirrhosis - pathology

Female

Hemosiderosis - complications

Details

Title: Subtitle: Hemosiderosis is associated with accelerated decompensation and decreased survival in patients with cirrhosis
Creators: Zeid Kayali - Division of Gastroenterology and Hepatology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
Rostislav Ranguelov
Frank Mitros
Chrisandra Shufelt
Farshad Elmi
Stephen C Rayhill
Warren N Schmidt
Kyle E Brown
Resource Type: Journal article
Publication Details: Liver international, Vol.25(1), pp.41-48
Publisher: United States
DOI: 10.1111/j.1478-3231.2005.01022.x
PMID: 15698397
ISSN: 1478-3223
eISSN: 1478-3231
Grant note: R01 AA13215-01 / NIAAA NIH HHS
Language: English
Date published: 02/2005
Academic Unit: Gastroenterology and Hepatology; Pathology; Radiation Oncology; Internal Medicine
Record Identifier: 9984047997602771

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