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Hematology. 2018 Dec;23(10):817-822. doi: 10.1080/10245332.2018.1488569. Epub 2018 Jun 19.

Hyperferritinemia: causes and significance in a general hospital.

Author information

1
a Internal Medicine , St. Luke's International Hospital , Tokyo , Japan.
2
b Division of Hematology , St. Luke's International Hospital , Tokyo , Japan.
3
c Center for Clinical Epidemiology , St. Luke's International Hospital , Tokyo , Japan.

Abstract

OBJECTIVE:

To elucidate conditions which cause elevation of the serum ferritin, extent of the elevation in each condition, and clinical relevance of hyperferritinemia in general practice.

METHODS:

We retrospectively studied medical records of all patients who had at least one serum ferritin measurement above 500 μg L-1. Patients who had a marked elevation of the serum ferritin over 10,000 μg L-1 were studied separately.

RESULTS:

We studied 1394 patients to identify the etiologies of hyperferritinemia. Median serum ferritin level was 1024 μg L-1 and 49.2% had ferritin levels of 501-1000 μg L-1. The most frequent cause of hyperferritinemia was non-human immunodeficiency virus infection followed by solid tumor, liver dysfunction, renal failure, and hematological malignancy. The distributions of the causes were different among groups stratified by the ferritin level. Forty-one percent had multiple causes and there was a tendency that the more underlying causes a patient had, the higher the ferritin level. Each condition led to a wide range of the ferritin level, and some patients could present with marked hyperferritinemia. Seventy percent of 111 patients with marked hyperferritinemia had multiple etiologies and a variety of diseases could lead to marked hyperferritinemia by themselves.

DISCUSSION:

Patients with hyperferritinemia frequently had multiple conditions. The level of the serum ferritin was determined by the underlying conditions to a certain extent; however, the variation was significant. While patients with marked hyperferritinemia mostly had multiple underlying causes, various diseases could cause hyperferritinemia by themselves.

CONCLUSION:

Hyperferritinemia is associated with both etiology and the number of underlying causes.

KEYWORDS:

Hyperferritinemia; etiology; ferritin; general practice; hemophagocytic lymphohistiocytosis

PMID:
29914346
DOI:
10.1080/10245332.2018.1488569
[Indexed for MEDLINE]

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