Hajime Senjo1, Takakazu Higuchi2, Sadamu Okada2, Osamu Takahashi3. 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.
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.
Entities:
Keywords:
Hyperferritinemia; etiology; ferritin; general practice; hemophagocytic lymphohistiocytosis
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