From the Guidelines
Elevated serum ferritin indicates excess iron storage in the body, which may suggest conditions like hemochromatosis, inflammation, liver disease, certain cancers, or metabolic syndrome, and requires further testing, including transferrin saturation, complete blood count, and liver function tests, to determine the underlying cause and guide treatment. Normal ferritin levels range from 20-250 ng/mL for men and 10-120 ng/mL for women, with levels above these ranges considered elevated 1. This finding may also be associated with other conditions, such as fatty liver disease, metabolic syndrome, or chronic inflammation.
Key Points to Consider
- Elevated ferritin doesn't always mean iron overload, as it's also an acute phase reactant that increases during inflammation 1.
- If ferritin is elevated, additional tests are necessary to determine the underlying cause, including transferrin saturation, complete blood count, and liver function tests 1.
- Treatment depends on the diagnosis - for true iron overload, it may include therapeutic phlebotomy (blood removal) to reduce iron levels, while for inflammatory conditions, addressing the underlying cause is necessary 1.
- Dietary modifications like reducing red meat, vitamin C, and alcohol intake may be recommended for those with iron overload 1.
- Regular monitoring of ferritin levels is important to track treatment effectiveness and prevent complications like organ damage from excessive iron deposition 1.
Diagnosis and Management
The diagnosis of hemochromatosis and other conditions associated with elevated ferritin requires a comprehensive approach, including clinical evaluation, laboratory tests, and genetic testing if necessary 1. The management of these conditions depends on the underlying cause and may involve therapeutic phlebotomy, dietary modifications, and treatment of underlying inflammatory or metabolic conditions.
Conclusion is not allowed, so the answer will be ended here.
From the Research
Elevated Serum Ferritin Meaning
Elevated serum ferritin levels can be associated with various conditions, including:
- Inflammatory conditions such as adult-onset Still's disease, systemic juvenile idiopathic arthritis, and hemophagocytic lymphohistiocytosis/macrophage activation syndrome 2
- Malignancy, which was the most frequent condition in a study of patients with markedly elevated serum ferritin levels 2
- Iron-overload syndromes, which were the second most common condition in the same study 2
- Infection, which can cause hyperferritinemia 3
- Hemophagocytic lymphohistiocytosis (HLH), which is a rare but potentially life-threatening condition characterized by extreme hyperferritinemia 3
- Anemia of chronic inflammation, which can also cause elevated serum ferritin levels 2
Clinical Significance
The clinical significance of elevated serum ferritin levels depends on the underlying cause. For example:
- In patients with hemochromatosis, therapeutic phlebotomy can be used to remove excess iron and maintain low normal body iron stores, and it should be initiated in men with serum ferritin levels of 300 microg/L or more and in women with serum ferritin levels of 200 microg/L or more 4
- In patients with extreme hyperferritinemia, the cut off of 6000 μg L-1 is significantly associated with HLH diagnosis, and the H score is an interesting screening tool that physicians should use to rule out the probability of HLH when facing critical clinical situations 3
- Elevated serum ferritin levels can also be associated with poor prognosis and critical clinical situations, particularly in patients with malignancy or infection 3
Diagnosis and Management
The diagnosis and management of elevated serum ferritin levels depend on the underlying cause. For example:
- In patients with iron overload, therapeutic phlebotomy can be used to remove excess iron and maintain low normal body iron stores 4
- In patients with inflammation or infection, treatment of the underlying condition can help to reduce serum ferritin levels 2, 3
- In patients with HLH, prompt recognition and treatment are critical to improve outcomes 3