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Differential Diagnosis for Elevated Ferritin without Iron Overload

  • Single most likely diagnosis
    • Inflammation: Elevated ferritin is a common finding in various inflammatory conditions, such as rheumatoid arthritis, due to its role as an acute-phase reactant. This is the most likely cause of elevated ferritin in the absence of iron overload.
  • Other Likely diagnoses
    • Liver disease: Ferritin can be elevated in liver diseases such as hepatitis, cirrhosis, and liver cancer, due to the liver's role in storing and regulating iron.
    • Cancer: Certain types of cancer, such as lymphoma and leukemia, can cause elevated ferritin levels.
    • Chronic diseases: Conditions like chronic kidney disease, diabetes, and obesity can also lead to elevated ferritin levels.
  • Do Not Miss diagnoses
    • Hemophagocytic lymphohistiocytosis (HLH): A rare but life-threatening condition characterized by excessive immune activation, which can cause very high ferritin levels.
    • Sepsis: In severe infections, ferritin can be elevated as part of the acute-phase response, and missing this diagnosis can be fatal.
  • Rare diagnoses
    • Hyperthyroidism: In some cases, hyperthyroidism can cause elevated ferritin levels, although this is a rare finding.
    • Gaucher's disease: A genetic disorder that affects the breakdown of fatty substances, which can lead to elevated ferritin levels.
    • Porphyrias: A group of rare genetic disorders that can cause elevated ferritin levels due to the accumulation of porphyrins.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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