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Significance of Hyperferritinemia in Hospitalized Adults.

Abstract Although high ferritin levels are associated with iron overload, it is known that ferritin is also an acute-phase reactant that may be elevated in conditions associated with acute and chronic inflammation. In addition, an elevated ferritin level is a criterion for the diagnosis of hemophagocytic lymphohistiocytosis/macrophage activation syndrome (HLH/MAS). Therefore, the significance of elevated serum ferritin is often unclear. As HLH/MAS is a medical emergency, prompt diagnosis is important to guide appropriate treatment.
PMID
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Authors

Mayor MeshTerms
Keywords

Ferritin

Hemophagocytic lymphohistiocytosis

Hyperferritinemia

Iron

Journal Title the american journal of the medical sciences
Publication Year Start




PMID- 28864373
OWN - NLM
STAT- MEDLINE
DA  - 20170902
DCOM- 20170908
LR  - 20170908
IS  - 1538-2990 (Electronic)
IS  - 0002-9629 (Linking)
VI  - 354
IP  - 2
DP  - 2017 Aug
TI  - Significance of Hyperferritinemia in Hospitalized Adults.
PG  - 152-158
LID - S0002-9629(17)30228-8 [pii]
LID - 10.1016/j.amjms.2017.04.016 [doi]
AB  - BACKGROUND: Although high ferritin levels are associated with iron overload, it
      is known that ferritin is also an acute-phase reactant that may be elevated in
      conditions associated with acute and chronic inflammation. In addition, an
      elevated ferritin level is a criterion for the diagnosis of hemophagocytic
      lymphohistiocytosis/macrophage activation syndrome (HLH/MAS). Therefore, the
      significance of elevated serum ferritin is often unclear. As HLH/MAS is a medical
      emergency, prompt diagnosis is important to guide appropriate treatment.
      MATERIALS AND METHODS: To study the spectrum of diagnoses associated with
      elevated serum ferritin, we did a retrospective review of adult patients admitted
      to our academic medical center from 2008-2012 with serum ferritin levels greater 
      than 2,000ng/mL. The degree of hyperferritinemia was compared to different
      diagnoses and selected laboratory values. RESULTS: A total of 333 patients were
      identified with a serum ferritin level >2,000ng/mL. Hepatocellular injury was the
      most prevalent diagnosis with n = 126; infection was next with n = 96. Eleven
      patients were diagnosed with HLH/MAS. CONCLUSIONS: Elevated ferritin, as an
      isolated finding, was not a specific marker for the diagnosis of HLH/MAS.
      However, as a group, HLH/MAS patients had the highest mean and median ferritin
      values.
CI  - Published by Elsevier Inc.
FAU - Schaffner, Meredith
AU  - Schaffner M
AD  - Department of Internal Medicine (MeS, MaS, ZB), Division of Hematology and
      Oncology (MeS), Division of Allergy and Immunology (ZB), University of Iowa
      Hospitals and Clinics, Iowa City, Iowa. Electronic address:
      [email protected]
FAU - Rosenstein, Lori
AU  - Rosenstein L
AD  - Department of Internal Medicine, Division of Hematology and Oncology (LR),
      Gundersen Health Systems, La Crosse, Wisconsin.
FAU - Ballas, Zuhair
AU  - Ballas Z
AD  - Department of Internal Medicine (MeS, MaS, ZB), Division of Hematology and
      Oncology (MeS), Division of Allergy and Immunology (ZB), University of Iowa
      Hospitals and Clinics, Iowa City, Iowa.
FAU - Suneja, Manish
AU  - Suneja M
AD  - Department of Internal Medicine (MeS, MaS, ZB), Division of Hematology and
      Oncology (MeS), Division of Allergy and Immunology (ZB), University of Iowa
      Hospitals and Clinics, Iowa City, Iowa. Electronic address:
      [email protected]
LA  - eng
PT  - Journal Article
DEP - 20170425
PL  - United States
TA  - Am J Med Sci
JT  - The American journal of the medical sciences
JID - 0370506
RN  - 9007-73-2 (Ferritins)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Female
MH  - Ferritins/*metabolism
MH  - Humans
MH  - Iowa/epidemiology
MH  - Iron Overload/*complications/*diagnosis
MH  - Lymphohistiocytosis, Hemophagocytic/*epidemiology/etiology
MH  - Macrophage Activation Syndrome/*epidemiology/etiology
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Ferritin
OT  - Hemophagocytic lymphohistiocytosis
OT  - Hyperferritinemia
OT  - Iron
EDAT- 2017/09/03 06:00
MHDA- 2017/09/09 06:00
CRDT- 2017/09/03 06:00
PHST- 2016/12/16 [received]
PHST- 2017/04/16 [revised]
PHST- 2017/04/20 [accepted]
AID - S0002-9629(17)30228-8 [pii]
AID - 10.1016/j.amjms.2017.04.016 [doi]
PST - ppublish
SO  - Am J Med Sci. 2017 Aug;354(2):152-158. doi: 10.1016/j.amjms.2017.04.016. Epub
      2017 Apr 25.