IPLab:Lab 5:Hemochromatosis

From Pathology Education Instructional Resource
Jump to: navigation, search

Contents

Clinical Summary

This 61-year-old female was first admitted to the hospital because of ascites and pedal edema. A liver biopsy revealed a marked intracellular accumulation of iron. The serum iron concentration was reported as 220 mcg/dLNormal serum iron levels are 35 to 160 micrograms/dL.. On the basis of these studies, the diagnosis of hemochromatosis was made. It should be noted that the patient also exhibited an abnormal glucose tolerance testThe glucose tolerance test (GTT) is a measure of active insulin and also reflects the power of normal liver to absorb and store large amounts of glucose. Following the administration of a 75-gram dose of glucose, blood glucose levels should return to normal in less than 3 hours. at this time (following the ingestion of a test dose of glucose, the blood glucose level rose to 290 mg/dLAfter glucose challenge, the blood glucose level should be back to 110 to 180 mg/dL by 2 hours. at one hour and remained at this level for the next three hours). Subsequent to the first admission, the patient was admitted on several occasions for ascites. The patient's last admission was necessitated by the development of symptoms and signs of hepatic failure (hepatic coma) characterized by jaundiceJaundice (or icterus) is a state of hyperbilirubinemia (increased bilirubin in the blood) in which bile pigment is deposited in the skin, mucous membranes, and scleras. This deposition of bile pigment results in a yellow appearance. and coma.

Autopsy Findings

The liver weighed 820 gramsA normal liver weighs 1650 grams (range: 1500 to 1800 grams).. The cut surface was described as golden-brown in color, having a fine, diffuse nodularity, and being extremely firm in consistency.

Images

Virtual Microscopy

H&E

Liver: Hemochromatosis

Normal Liver

Prussian Blue

Study Questions


Additional Resources

Reference

Journal Articles

Images

Related IPLab Cases