Primary hyperoxaluria type I: ultrastructural observations in liver biopsies.

The liver ultrastructure of four patients with the peroxisomal disease primary hyperoxaluria type I has been investigated. In all cases, peroxisomes of normal appearance were present in the parenchymal cells, except that they were somewhat reduced in number and size. In all patients, conspicuous lipofuscin was present, presumably resulting from the various metabolic disturbances to which the livers were subjected during the course of their disease. Considerable hepatocyte iron overloading was found in the three patients who had been hemodialyzed and/or had blood transfusions. Whether the relatively mild peroxisomal abnormalities (as compared to other peroxisomal diseases, such as Zellweger's syndrome) found in these hyperoxaluric patients are related directly to the peroxisomal deficiency of alanine:glyoxylate aminotransferase, or whether they are a secondary phenomenon, resulting from the consequent metabolic disturbance, remains to be elucidated.