Elevated Ferritin Differential
Elevated ferritin levels can be caused by a variety of conditions, ranging from benign to life-threatening. Here's a differential diagnosis organized into categories:
- Single most likely diagnosis
- Hemochromatosis: A genetic disorder characterized by excessive iron absorption, leading to elevated ferritin levels. It's a common cause of elevated ferritin, especially in individuals of European descent.
- Other Likely diagnoses
- Inflammation or Infection: Conditions like rheumatoid arthritis, lupus, or chronic infections can cause elevated ferritin levels due to the body's inflammatory response.
- Liver Disease: Liver conditions such as cirrhosis, hepatitis, or non-alcoholic fatty liver disease can lead to elevated ferritin levels.
- Cancer: Certain types of cancer, including lymphoma, leukemia, and hepatocellular carcinoma, can cause elevated ferritin levels.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Sepsis: Although less common, sepsis can cause elevated ferritin levels, and missing this diagnosis can be fatal.
- Hemophagocytic Lymphohistiocytosis (HLH): A rare but life-threatening condition characterized by excessive immune activation, which can cause elevated ferritin levels.
- Acute Hemolysis: Conditions like hemolytic anemia can cause elevated ferritin levels, and prompt diagnosis is crucial to prevent severe complications.
- Rare diagnoses
- Porphyria Cutanea Tarda: A rare genetic disorder that can cause elevated ferritin levels, characterized by skin blistering and photosensitivity.
- Aceruloplasminemia: A rare genetic disorder that affects iron metabolism, leading to elevated ferritin levels and neurological symptoms.
- Hyperthyroidism: In some cases, hyperthyroidism can cause elevated ferritin levels, although this is a rare association.
It's essential to consider the patient's clinical presentation, medical history, and laboratory results to narrow down the differential diagnosis and guide further evaluation and management.