Back to Search
Start Over
Prolonged exposure to welding fumes as a novel cause of systemic iron overload
- Source :
- Liver International
- Publication Year :
- 2021
- Publisher :
- Wiley, 2021.
-
Abstract
- Background & Aims: Inhalation of welding fume may cause pulmonary disease known as welder's lung. At our centre we came across a number of welders with systemic iron overload and prolonged occupational history and we aimed at characterizing this novel clinical form of iron overload. Methods: After exclusion of other known causes of iron overload, 20 welders were fully evaluated for working history, hepatic, metabolic and iron status. MRI iron assessment was performed in 19 patients and liver biopsy in 12. We included 40 HFE-HH patients and 24 healthy controls for comparison. Results: 75% of patients showed lung HRCT alterations; 90% had s-FERR > 1000 ng/mL and 60% had TSAT > 45%. Liver iron overload was mild in 8 and moderate-severe in 12. The median iron removed was 7.8 g. Welders showed significantly lower TSAT and higher SIS and SIS/TIS ratio than HFE-HH patients. Serum hepcidin was significantly higher in welders than in HFE-HH patients and healthy controls. At liver biopsy, 50% showed liver fibrosis that was mild in four, and moderate-severe in two. Liver staging correlated with liver iron overload. Conclusions: Welders with prolonged fume exposure can develop severe liver iron overload. The mechanism of liver iron accumulation is quite different to that of HFE-HH suggesting that reticuloendothelial cells may be the initial site of deposition. We recommend routine measurement of serum iron indices in welders to provide adequate diagnosis and therapy, and the inclusion of prolonged welding fume exposure in the list of acquired causes of hyperferritinemia and iron overload.
- Subjects :
- medicine.medical_specialty
Iron Overload
Iron
Liver fibrosis
Gastroenterology
lung
03 medical and health sciences
0302 clinical medicine
Hepcidin
welder
Internal medicine
medicine
Humans
Welding
Genetics and Rare Liver Diseases
liver fibrosis
Lung
Hepatology
medicine.diagnostic_test
biology
Inhalation
business.industry
ferritin
liver fibrosi
Mononuclear phagocyte system
Ferritin
medicine.anatomical_structure
Liver
030220 oncology & carcinogenesis
Liver biopsy
Serum iron
biology.protein
Original Article
030211 gastroenterology & hepatology
hepcidin
business
Subjects
Details
- ISSN :
- 14783231 and 14783223
- Volume :
- 41
- Database :
- OpenAIRE
- Journal :
- Liver International
- Accession number :
- edsair.doi.dedup.....16424222b61515d6a2685818e29028db