Dysmetabolic iron overload syndrome: a mild but unquestionable iron overload is identified by MRI

Castiella et al. claim that liver iron concentration (LIC) is not increased in patients with hyperferritinemia and metabolic syndrome on the basis of a study[1] in which LIC was measured using magnetic resonance imaging (MRI) in 54 patients referred for hyperferritinemia. However, this study has a major limitation, because 5% of patients had viral hepatitis and 35% were excessive drinkers (u003e40 g/day), two conditions that can induce hyperferritinemia without iron overload.