Section of Internal medicine of Institute of Medical Science Mongolia
Background and purpose: Liver disease that caused by iron metabolism failure is called Hemochromatosis (clinically "Bronze diabetes", "Over spotted liver cirrhosis"). The two types of hemochromatosis are primary and secondary. Primary hemochromatosis is caused by a defect in the genes that control how much iron the human body absorb from food. Secondary hemochromatosis usually is the result of another disease or condition that causes iron overload. According to the study there is a real need to study the clinical reveals of hemachromatosis in Mongolian patients. The purpose of the study to determine the hemachromalosis in patients with liver cirrhosis and cancer.
Materials and Methods: The study involved 50 patients with diagnosis liver cirrhosis and cancer (I-stage) who were hospitalized in Clinic of gastroenterology of Shastin clinical hospital and "Shagdarsuren" hepatic hospital from April to July. 2011. The special questionnaire was used in the study. The biochemical laboratory examinations were taken and analyzed in lab "MED ANALYTIC". Biochemical tests performed on HumaStar 80 fully automatic analyzer. Determination of Iron level was performed by Photometric colorimetric test for iron with lipid clearing factor (normality 37-148ug/dl), transferring level by Turbidimelric monoreagent for the quantitative determination of transferring (normality 170-340ug/dl), glucose level by (GOD-PAP method) Enzymatic colorimetric test for glucose method without Deproteinisation (normality 75-115ug/dl). The ferritin level performed by ELISA analyzer (normality 15-240ng/ml).
Results: The patient's age was 25-86, the mid aging-55.42. From all patients (29 male and 21 female) who were participated in the study, the 25 were with diagnosis liver cirrhosis and 18 of them clinically has the Child Pugh "B" cirrhosis. 7 has Child Pugh "A". The other 25 patients were with diagnosis liver cancer first stage.
According to biochemical analyzes iron (n=35;70%); ferritin (n=41;82%): transferring (n=27; 54%); sugar (n=21;42%) levels were elevated.
During the liver disease caused by iron overloading the following clinical symptoms were observed:
- Skin spotting, n=48 (98%)
Hepatomegaly, n=33 (66%) Splenomegaly, n=28 (56%)
- Diabetes mellitus symptoms, n= 30 (60%) Cardiovascular disease, n=16 (32%) Respiratory system disorders, n=11 (22%)
- Gonadotroph^ n= 2 (4%)
The average serum iron level in case of liver cirrhosis was 189.84±18.5mg/dl, in liver cancer 160.4±13.91 mg/ dl, ferritin level in case of liver cirrhosis was 407.69±50.08ng/ml. transferrin 375.68±47.38mg/dl. glucose 121.1±7.15mg/dl, ferritin level in liver cancer was 391.67±47.79ng/ml, transferring 388.76±47.38mg/dl, glucose 114.59±5.78mg/dl.
