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Variability in Hepatic Iron Concentration in Percutaneous Needle Biopsy Specimens From Patients With Transfusional Hemosiderosis

Ellen Butensky PhD, PNP, Roland Fischer PhD, Mark Hudes, Laurie Schumacher PhD, Roger Williams MD, Thomas P. Moyer PhD, Elliott Vichinsky MD, Paul Harmatz MD
DOI: http://dx.doi.org/10.1309/PUUXEGXDLH26NXA2 146-152 First published online: 1 January 2005


In patients with sickle cell disease or β-thalassemia receiving RBC transfusions for a long period, a precise knowledge of the liver iron concentration (LIC) is essential for treatment. Patients underwent LIC and liver pathology assessment by duplicate biopsies in 2 passes from the same local liver site. Fresh tissue cores in trace element–free containers and tissues from dissolved paraffin-embedded cores were analyzed. LIC measurements in each of 2 paraffin-embedded cores did not differ significantly (median, 12,455 vs 12,153 μg/g dry weight; n = 29). A significant difference was observed when 1 fresh tissue sample and 1 paraffin-embedded core were analyzed (median, 11,716 vs 12,864 μg/g dry weight; n = 16; P < .001) with a median disagreement between LIC measurements of 23.0%. We found high agreement in LICs between liver biopsy specimens processed by the paraffin-embedding technique but overestimation of LICs in comparison with desiccated fresh tissue samples.

Key Words:
  • Thalassemia
  • Sickle cell
  • Liver iron concentration
  • Liver biopsy
  • Paraffin
  • Fresh tissue