ETIOLOGICAL STUDY OF MARKEDLY ELEVATED SERUM FERRITIN LEVELS IN A TERTIARY HEALTH CARE CENTRE
Main Article Content
Keywords
.
Abstract
Ferritin, a store of iron in soluble nontoxic form, reflects total body iron stores. It protects the cell from iron-mediated oxidation-reduction reactions. It plays a role as an acute-phase reactant and has long-standing association with rheumatologic diseases eg. adult-onset Still's disease, systemic juvenile idiopathic arthritis and hemophagocytic lymphohistiocytosis / macrophage activation syndrome.1,2 The cause may be increased synthesis due to genetic or acquired effect usually seen in diseases like malignancies, hyperferritinemia-cataract syndrome. This may also be due to increased release from damaged cells eg. in acute myocardial infarction, liver disorders. However, making a definitive diagnostic link between a markedly elevated serum ferritin determination and a specific diagnosis, rheumatologic or otherwise, can be challenging as the manifestations of these diseases are often protean and can easily be mistaken for other conditions such as sepsis with multiple organ failure or malignancy. 2,3
References
2. Hee-Taik Kang, John A. Linton, Soon Kil Kwon, Byoung-Jin Park and Jong Hun Lee. Ferritin Level Is Positively Associated with Chronic Kidney Disease in Korean Men, Based on the 2010–2012 Korean National Health and Nutrition Examination Survey. Int. J. Environ. Res. Public Health 2016, 13, 1058; doi:10.3390/ijerph13111058
3. C Moore, Jr, MD; Michelle Ormseth, MD; Howard Fuchs, MD. Hyperferritenemia >1650ng/ml Causes and Significance of Markedly Elevated Serum Ferritin Levels in an Academic Medical Center. J Clin Rheumatol.2013;19(6):324-328.
4. Rosario, C., Zandman-Goddard, G., Meyron- Holtz, E.G., D’Cruz, D.P. & Shoenfeld, Y. (2013) The hyperferritinemic syndrome: macrophage activation syndrome, Still’s disease, septic shock and catastrophic antiphospholipid syndrome. BMC Medicine, 11, 185.
5. Schram, A.M., Campigotto, F., Mullally, A., Fogerty, A., Massarotti, E., Neuberg, D. & Berliner, N. (2015) Marked hyperferritinemia does not predict for HLH in the adult population. Blood, 125, 1548–1552.
6. Allen, C.E., Yu, X., Kozinetz, C.A. & McClain, K.L. (2008) Highly elevated ferritin levels and the diagnosis of hemophagocytic lymphohistiocytosis. Pediatric Blood Cancer, 50, 1227–1235.
7. Sandnes, M.; Ulvik, R.J.; Vorland, M.; Reikvam, H. Hyperferritinemia—A Clinical Overview. J. Clin. Med. 2021, 10, 2008. https://doi.org/10.3390/jcm10092008.
8. VanWagner LB, Green RM. Elevated serum ferritin. JAMA. 2014 Aug 20;312(7):743-4. doi: 10.1001/jama.2014.302. PMID: 25138336; PMCID: PMC4424930.
9. Peng Cao, Yuanjue Wu, Sanlan Wu, Tingting Wu, Qilin Zhang, Rui Zhang, Zhao Wang & Yu Zhang (2021) Elevated serum ferritin level effectively discriminates severity illness and liver injury of coronavirus disease 2019 pneumonia, Biomarkers, 26:3, 207-212, DOI: 10.1080/1354750X.2020.1861098
10. Mao W, Hu Y, Lou Y, Chen Y, Zhang J. Abnormal serum iron markers in chronic hepatitis B virus infection may be because of liver injury. Eur J Gastroenterol Hepatol. 2015 Feb;27(2):130-6. doi: 10.1097/MEG.0000000000000247. PMID: 25419642; PMCID: PMC4280275
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr Sulekha Sinha
Professor, Department of Biochemistry, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, India
Dr Bikramaditya Mukherjee
Assistant Professor, Department of Biochemistry, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, India
Dr Chinmaya Dash
Professor, Department of Microbiology, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, India
Mr. Monit Sundriyal
Tutor, Department of Biochemistry, Manipal Tata Medical College, Manipal Academy of Higher Education, Manipal, India