Uneven element distribution in alcoholic liver disease. A case report

Background: Chronic ethanol consumption is often associated with modifications in the liver content of several trace elements. Being associated with ongoing fibrogenesis, increases in iron and copper and the decrease in zinc liver stores may play a significant role in the progression of alcoholic liver disease (ALD). It seemed of interest to determine the hepatic Fe, Cu, Zn, P, S, and Mg distribution in an autoptic case of ALD. Case Report: A liver slice was divided into 63 samples, and each one in two symmetrical parts: one was utilized to quantify trace elements by Induced Coupled Plasma-Atomic Emission Spectroscopy (ICP-AES). Our data confirm that ALD is associated with marked changes in trace element status in the liver. In particular, the increase in iron and copper and the decrease in zinc are confirmed. Moreover, we give evidence of an irregular, uneven distribution of all elements studied throughout the liver, with marked differences in content even among adjacent samples. Conclusions: Given the observed sampling variability of all studied elements, we suggest caution when considering the dosage obtained from a small part of a liver needle biopsy for clinical purposes as representative of the mean metal liver content.