Ultrastructural features of sidero - apoptotic hepatocytes in thalassemia.

Liver tissues from 20 patients with thalassemia were investigated by light and electron microscopy, with focus on ultrastructure of sidero-apoptosis. The results of light microscopy were compared. Sidero-apoptosis was found in 82% in b thal/Hb E disease, 67% in thalassemia Hb H, 100% in and b-thal major, respectively. Regardless of the type of hemoglobin, sidero-apoptosis was present in various degrees. The main criteria used for identification of sidero-apoptosis were marked condensation of chromatin against the nuclear membrane, and fragmentation into nuclear fragments of varying sizes and structures into membrane-bounded sidero-apop-totic bodies. These bodies may be phagocytosed by macrophages or neighboring cells or remain free. However, the cell may also shrink into a dense, rounded mass, as a single sidero-apoptotic body. Sidero-apoptoic bodies were similar to acidophilic bodies, or Councilman bodies, commonly found in viral hepatitis. This preliminary report suggestsd that sidero-apoptosis is a features of human liver pathology in thalassemia and may be due to hepatotoxicity of iron overload. In addition, many factors or other agents-hormone, killer cells, cytokines, various physical, chemical and viral agents should be considered. We propose the term "sidero-apoptosis" to describe the features resenbling acidophilic bodies commonly seen in viral hepatitis but with a heavy depositi of iron.

Electron microscopical and immunohistochemical studies of liver tissue in thalassaemic patients: Emphasis on iron and hepatitis B virus.

Fine structure and immunohistochemical studies were investigated in 30 thalassaemic patients. They were diagnosed as having beta thalassemis/haemoglobin E in 19 cases, haemoglobin H disease in 7, and beta thalassemia major in 4. Regardless of the type of haemoglobin, lysosomal haemosiderin was present in various degrees in all cases and some were associated with ferritin molecules. The ferritin molecules were found in both cell sap and lysosome, in four forms: paracrystalline arrangement, hexagonal pattern, finger print fashion and unorganized form. By peroxidase-anti peroxidase (PAP) technique for the detection of hepatitis B surface (HBs) and hepatitis B core (HBc) antigens, HBsAg was found in 1 case of beta thalassemia/Hb E. Ferro-acidophilic bodies (FAB) and ferro-acidophilic degeneration (FAD) were also found. FAB and FAD were probably due to iron hepatotoxicity, because no viral particles were found in this study.