Differential ferrioxamide test in haemochromatosis and liver disease

The effect of desferrioxamine is examined in more than 100 patients with liver disease, including haemochromatosis, using the differential ferrioxamine test. The procedure gives a reasonably accurate estimate of the size of the iron stores, as determined by multiple venesection, in patients with idiopathic haemochromatosis. Since desferrioxamine is not specific for storage iron, unequivocally abnormal results are not obtained unless the iron load exceeds about 2·3 g. In other forms of liver disease the effect of desferrioxamine is generally increased compared with that in controls. The results show no correlation with the serum iron level or the degree of hepatic siderosis. High values are usual in the presence of jaundice and overlap the range found in untreated haemochromatosis, adding to other evidence that desferrioxamine can derive iron from a hyperchelatable source unrelated to the stores. It is concluded that in liver diseases other than haemochromatosis the results of the test do not reliably reflect body storage iron content.