From the Guidelines
Elevated ferritin (hyperferritinemia) indicates excessive iron storage in the body or an inflammatory response, and requires medical attention to prevent potential organ damage, as stated in the most recent guidelines 1.
Causes of Hyperferritinemia
The primary causes of hyperferritinemia include:
- Hemochromatosis, a genetic disorder characterized by excessive iron absorption
- Chronic inflammation, which can lead to increased ferritin production
- Liver disease, such as cirrhosis or hepatitis
- Certain cancers, such as lymphoma or leukemia
- Metabolic syndrome, a cluster of conditions that increase the risk of developing type 2 diabetes and cardiovascular disease
- Excessive alcohol consumption, which can lead to liver damage and increased ferritin production
Diagnosis and Treatment
When hyperferritinemia is detected, further testing is usually needed to determine the underlying cause, including:
- Transferrin saturation, to assess iron binding capacity
- Complete blood count, to evaluate for anemia or other blood disorders
- Liver function tests, to assess liver damage or disease
- Possibly genetic testing for hereditary hemochromatosis, if suspected Treatment depends on the cause, but may include:
- Therapeutic phlebotomy, to remove excess iron from the body
- Addressing underlying inflammation, through medication or lifestyle changes
- Managing underlying conditions, such as liver disease or cancer
Importance of Early Detection and Treatment
Early detection and treatment of hyperferritinemia are crucial to prevent potential organ damage, including:
- Cirrhosis, or scarring of the liver
- Heart failure, due to iron overload
- Diabetes, due to pancreatic damage
- Other serious complications, such as arthritis or hypogonadism As noted in the guidelines, elevated ferritin levels can indicate increased tissue iron concentrations, but are also non-specific, and may require further testing to determine the underlying cause 1.
From the Research
Elevated Ferritin (Hyperferritinemia) Indications
Elevated ferritin levels, also known as hyperferritinemia, can indicate various conditions, including:
- Iron overload, which can occur in hereditary hemochromatosis (HH) 2, 3, 4
- Transfusional iron overload in patients with thalassemia major or other anemias 5, 3, 6
- Secondary hemochromatosis following bone marrow transplantation 6
- Inflammation or infection, as ferritin is an acute-phase reactant 3
Conditions Associated with Elevated Ferritin
Some conditions associated with elevated ferritin levels include:
- Hereditary hemochromatosis (HH), a genetic disorder characterized by increased intestinal iron absorption 2, 4
- Thalassemia major, a genetic disorder affecting hemoglobin production 5
- Sickle cell disease, a genetic disorder affecting hemoglobin production 3
- Myelodysplastic syndromes, a group of disorders affecting blood cell production 3
- Aplastic anemia, a rare disorder affecting blood cell production 3, 6
Treatment of Iron Overload
Treatment of iron overload, which can be indicated by elevated ferritin levels, may involve: