Evaluation of peritoneal fluid hemosiderin-laden macrophages in biopsy-proven endometriosis.

Objective: To evaluate peritoneal fluid hemosiderin-laden macrophages (H-LMs) in patients with endometriosis compared to controls.

Study Design: Consecutive series of 46 patients during a year undergoing laparoscopy for benign gynecologic conditions were included. The presence of H-LMs in peritoneal fluid was evaluated. We compared clinical factors in patients with or without endometriosis in respect to H-LM status. To assess the potential of H-LMs to diagnose endometriosis, the sensitivity and specificity were calculated.

Results: Patients with endometriosis were significantly more likely to have positive H-LM test results than controls (p = 0.0013). The presence of H-LM has a low sensitivity of 52% but an acceptable specificity of 87% in diagnosing endometriosis. The presence of H-LMs was not related with any other of the clinical factors studied.

Conclusion: The presence of specific findings of H-LMs related to endometriosis strongly suggests abnormalities in peritoneal iron metabolism.