Liver
iron content was evaluated by a magnetic resonance imaging-based method in 20 consecutive patients with either sporadic or familial
porphyria cutanea tarda. Serum
ferritin,
hepatitis C infection and the presence of the 2 main mutations of the
hemochromatosis gene were also investigated. All patients showed good clinical response to phlebotomy. Initial liver
iron content was normal (< 40 micromol/g) in 9 cases, slightly increased (40-59 micromol/g) in 3 cases, moderately increased (60-99 micromol/g) in 6 cases or markedly increased (100-199 micromol/g) in 2 cases). The
ferritin level was raised (> 400 ng/ml) in 14/20 patients and there was no obvious relationship with liver
iron. Increased liver
iron content was observed more frequently in patients with
hemochromatosis mutation and less frequent in those with
hepatitis C infection. Clinical response to phlebotomies was slightly better in patients with increased liver
iron content even slightly, but patients with normal liver
iron content also responded well, which suggests that
iron depletion is an outstanding treatment independent of liver
iron content. This study shows that increased liver
iron content is not a constant finding in patients with
porphyria cutanea tarda, especially in women, and that it is not a prerequisite for the efficiency of phlebotomy.