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.