What is the differential diagnosis for elevated ferritin (iron storage protein) levels?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 26, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for High Ferritin

  • Single most likely diagnosis
    • Iron overload (Hemochromatosis): This is a condition where the body absorbs too much iron from food, leading to a buildup of iron in the body. High ferritin levels are a hallmark of this condition, as ferritin is a protein that stores iron.
  • Other Likely diagnoses
    • Hemosiderosis: This condition involves the accumulation of hemosiderin, a protein that stores iron, in tissues. It can be caused by multiple blood transfusions, chronic hemolysis, or other conditions.
    • Chronic inflammation: Conditions such as rheumatoid arthritis, chronic infections, or other inflammatory diseases can cause an increase in ferritin levels due to the body's inflammatory response.
    • Liver disease: Certain liver conditions, such as cirrhosis or liver cancer, can lead to elevated ferritin levels.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Hemophagocytic lymphohistiocytosis (HLH): This is a rare but life-threatening condition characterized by an overactive immune response, which can cause high ferritin levels. Missing this diagnosis can be fatal.
    • Sepsis: In severe sepsis, ferritin levels can be elevated due to the body's inflammatory response. Early recognition and treatment of sepsis are crucial to prevent mortality.
  • Rare diagnoses
    • Porphyria cutanea tarda: This is a rare genetic disorder that affects the production of heme, leading to an accumulation of iron in the body and elevated ferritin levels.
    • Erythroleukemia: A type of blood cancer that can cause an increase in ferritin levels due to the abnormal production of red blood cells.
    • Gaucher's disease: A rare genetic disorder that affects the breakdown of fatty substances in the body, leading to an accumulation of iron and elevated ferritin levels.

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.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.