From the Guidelines
Hyperferritinemia, or elevated iron levels, can lead to severe complications, including liver disease, heart problems, diabetes, and joint pain, and should be treated promptly with phlebotomy or chelation therapy to reduce iron stores and prevent further organ damage. The implications of hyperferritinemia are significant, and if left untreated, can lead to increased morbidity and mortality. According to the study by 1, phlebotomy remains the mainstay of treatment for hemochromatosis, and can lead to improved survival, improved sense of well-being, and improved cardiac function.
The treatment approach for hyperferritinemia typically involves removing one unit of blood (about 200-250 mg iron) weekly until iron levels normalize, then maintenance sessions every 2-4 months 1. Chelation options, such as deferasirox, deferoxamine, or deferiprone, may also be considered, depending on the cause and severity of iron overload. Dietary modifications, including limiting red meat, vitamin C with meals, and alcohol, may also be recommended.
Regular monitoring of ferritin, transferrin saturation, and organ function is essential during treatment to ensure iron levels are normalizing without complications. A study by 1 found that high ferritin levels were associated with an increased risk of acute cardiocerebrovascular disease, infections, and death in hemodialysis patients, highlighting the importance of prompt treatment.
Key points to consider in the treatment of hyperferritinemia include:
- Phlebotomy is the primary treatment for hemochromatosis
- Chelation therapy may be considered in certain cases
- Dietary modifications can help reduce iron intake
- Regular monitoring of iron levels and organ function is crucial
- High ferritin levels are associated with increased risk of complications, including cardiocerebrovascular disease, infections, and death.
Overall, hyperferritinemia is a serious condition that requires prompt treatment to prevent long-term complications and improve quality of life.
From the Research
Implications of Hyperferritinemia
The implications of hyperferritinemia, or elevated iron levels, can be severe and far-reaching. Some of the key implications include:
- Iron overload and toxicity, which can lead to morbidity and mortality in patients with thalassemia 2
- Increased risk of cardiac failure, diabetes, and malignant transformation 3
- Potential for reversible but severe arthropathy as a side effect of certain treatments, such as deferiprone 4
Effects on Organ Function
Hyperferritinemia can have significant effects on organ function, including:
- Cardiac function: iron overload can lead to cardiac failure, and reduction in iron levels can improve cardiac function 2, 5
- Liver function: iron overload can lead to liver fibrosis, and reduction in iron levels can decrease liver iron content and improve liver function 6
Treatment Options
Several treatment options are available to reduce iron levels and alleviate the implications of hyperferritinemia, including:
- Deferiprone/deferoxamine combination therapy 2
- Deferiprone monotherapy 2
- Combined therapy with desferrioxamine and deferiprone 5
- Triple combination therapy with deferoxamine, deferasirox, and deferiprone 4
- Phlebotomy program and iron chelating treatment 6
Importance of Iron Level Management
Effective management of iron levels is crucial to prevent long-term complications of iron overload and maintain labile iron and total body iron levels within a normal range 3. This can be achieved through a combination of treatment options and regular monitoring of iron levels and organ function.