case_images: PMC1318467_01
case_images: Perl's Prussian Blue stain for iron shows a typical pattern of iron accumulation seen in heterozygous GH (Patient A) (x20)
case_images: 1471-5945-5-12-1.jpg
case_images: PMC1318467_01_1471-5945-5-12-1.jpg
case_images: F1
case_images: Acinar zone 1, grade 1 parenchymal iron accumulation, with an acinar gradient, suggestive of heterozygous form of GH was seen with Perl's Prussian Blue (figure 1); iron was not detected in sinusoidal Kupffer cells or macrophages.
case_images: PMC1318467_02
case_images: Grade 3 hepatocyte iron accumulation with an acinar distribution pattern consistent with homozygous GH (Patient B) (Perl's Prussian Blue: x10).
case_images: 1471-5945-5-12-2.jpg
case_images: PMC1318467_02_1471-5945-5-12-2.jpg
case_images: F2
case_images: Grade 3 parenchymal iron accumulation, with an acinar gradient, was seen in acinar zone 1 (Figure 2) suggestive of homozygous GH.
case_images: Following venesection (Patient B), there is no histological evidence of residual iron (x20).
case_images: 1471-5945-5-12-3.jpg
case_images: PMC1318467_02_1471-5945-5-12-3.jpg
case_images: F3
case_images: He had another liver biopsy in October 2001 (total cumulative methotrexate dose of 7880 mg) which showed moderate steatosis, moderate to severe steatohepatitis, marginal perivenular fibrosis but no residual iron (Figure 3); the former features were reminiscent of alcohol-induced liver damage (Figure 4).
case_images: This figure shows a reticulin (a) and a Haematoxylin Van Gieson stain (b) of two terminal hepatic venules in which there is equivocal perivenular fibrosis (x40).
case_images: 1471-5945-5-12-4.jpg
case_images: PMC1318467_02_1471-5945-5-12-4.jpg
case_images: F4
case_images: He had another liver biopsy in October 2001 (total cumulative methotrexate dose of 7880 mg) which showed moderate steatosis, moderate to severe steatohepatitis, marginal perivenular fibrosis but no residual iron (Figure 3); the former features were reminiscent of alcohol-induced liver damage (Figure 4).