To the Editor:—
Your editorial, "Heredity and Environment in Idiopathic Hemochromatosis" (210:898, 1969), is correct in citing evidence that hemochromatosis occurs in the absence of dietary sources of excess iron, and in questioning the attribution of too many "idiopathic" cases to excess dietary iron.1 The environmental hypothesis was more fully stated elsewhere as "... a variant of portal (alcohol, nutritional) cirrhosis or, more important, accompanying the factors that cause certain kinds of cirrhosis; occasionally it is the result of two coexisting conditions, one causing cirrhosis and the other excess tissue iron" (Arch Intern Med112:184, 1963). It has been found that iron absorption is increased in cirrhosis (Gastroenterology43:385, 1962) and in chronic pancreatic disease (Lancet2:6, 1962), both of which are present in hemochromatosis.An important aspect of the publication cited in the editorial that requires critical examination is equating an abnormal laboratory test, such as