Scottish Trace Element and Micronutrient Reference Laboratory

Scotland's specialised laboratory for trace elements and vitamins in health and disease

Iron

Trace Elements

Vitamins

Specialised services

Chronic iron accumulation in diseases such as haemochromatosis or thalassaemia can be confirmed by direct measurement of iron in a liver biopsy or by carrying out a Desferal (desferrioxamine) test. This involves giving the patient an intramuscular injection of the chelating agent, Desferal, and collecting the urine excreted over the following six hours. Iron is normally excreted via the faecal route and urinary iron concentrations are low (about 0.5 µmol/L): following Desferal injection, urine iron normally increases by up to 18 µmol/L, whereas in patients with a storage abnormality, urine iron increases to over 50 µmol/L.

The Hepatic Iron Index (liver iron concentration in µmol/g divided by the patient's age in years) was proposed by Bassett et al to differentiate genetic haemochromatosis from alcoholic siderosis, both of which result in increased liver iron concentrations. This index exceeds 1.9 in haemochromatosis but not in heterozygotes or alcoholic liver disease. The index has been evaluated in several centres and shown to be a useful diagnostic tool.

Sample Requirements and Reference Values

Alan Kelly determining iron in urine by flame atomic absorption spectrometry

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