From the Guidelines
Elevated ferritin levels are often associated with nonspecific symptoms such as weakness, fatigue, lethargy, apathy, weight loss, abdominal pain, arthralgias, and diabetes, as seen in patients with hemochromatosis 1.
Common Symptoms
The symptoms of elevated ferritin can be categorized into nonspecific, systemic symptoms and specific, organ-related symptoms.
- Nonspecific symptoms include:
- Weakness
- Fatigue
- Lethargy
- Apathy
- Weight loss
- Specific symptoms include:
- Abdominal pain (hepatomegaly)
- Arthralgias (arthritis)
- Diabetes (pancreas)
- Amenorrhea (cirrhosis)
- Loss of libido, impotence (pituitary, cirrhosis)
- Congestive heart failure (heart)
- Arrhythmias (heart)
Underlying Conditions
Elevated ferritin levels can result from various conditions, including inflammation, liver disease, certain cancers, metabolic syndrome, or genetic disorders affecting iron metabolism 1. It's essential to determine the underlying cause of elevated ferritin, as treatment should target the specific condition rather than just the ferritin level itself. In some cases, elevated ferritin may be related to conditions such as adult-onset Still's disease, which can present with fever, joint pain, and liver abnormalities 1. However, the symptoms and underlying conditions associated with elevated ferritin can vary widely, and a thorough medical evaluation is necessary to determine the cause and appropriate treatment. The severity of symptoms typically correlates with how high ferritin levels are and how long they've been elevated, emphasizing the importance of prompt medical attention for unexplained elevated ferritin levels 1.
From the Research
Symptoms of Elevated Ferritin
The symptoms of elevated 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 is the most frequent condition associated with elevated ferritin levels 2
- Iron-overload syndromes, which are the second most common condition associated with elevated ferritin levels 2
- Anemia of chronic inflammation 2
- Transfusional iron overload, which can occur in patients with chronic anaemia such as beta-thalassaemia major and sickle cell disease 3, 4, 5, 6
Conditions Associated with Elevated Ferritin
Elevated ferritin levels can be found in patients with:
- Rheumatologic diseases, although extremely elevated ferritin levels are more often associated with other conditions such as malignancy or infection 2
- Seemingly indolent disease or levels of chronic inflammation 2
- Myelodysplastic syndromes (MDS) and myeloproliferative neoplasms (MPN) 5
- Aplastic anemia (AA) 6
Treatment of Elevated Ferritin
Treatment of elevated ferritin levels often involves iron chelation therapy, such as:
- Deferasirox, which is an oral iron chelator that has been shown to be effective in reducing serum ferritin and liver iron concentration in patients with transfusional iron overload 3, 4, 5, 6
- Deferoxamine, which is a traditional therapy for iron overload that is typically administered via overnight infusion multiple nights per week 3