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or treatment (e.g. blood transfusion or iron infusion) that lead to a genuine increase in RES iron stores. Upper limit of the normal range for serumferritin Most UK laboratories simply report 300–400 μg/l as the upper limit of normal for SF in adult males and 150–200 μg/l as the upper limit of normal for adult females (Association for Clinical Biochemistry, ; Worwood et al , ). There is however considerable variation in SF values in response to age, ethnic origin and sex. Mean SF values in neonates (...) , are outside the scope of this guideline, and readers are directed to the recently updated management guideline for this condition (Fitzsimons et al , ). Table 1. Causes of raised serumferritin Increased ferritin synthesis due to iron accumulation Increase in ferritin synthesis not associated with significant iron accumulation Increased ferritin as a result of cellular damage Hereditary (genetic) haemochromatosis Hereditary acaeruloplasminaemia Secondary iron overload from blood transfusion or excessive
Limitations of SerumFerritin in Diagnosing Iron Deficiency in Inflammatory Conditions Patients with inflammatory conditions such as inflammatory bowel disease (IBD), chronic heart failure (CHF), and chronic kidney disease (CKD) have high rates of iron deficiency with adverse clinical consequences. Under normal circumstances, serumferritin levels are a sensitive marker for iron status but ferritin is an acute-phase reactant that becomes elevated in response to inflammation, complicating (...) the diagnosis. Proinflammatory cytokines also trigger an increase in hepcidin, which restricts uptake of dietary iron and promotes sequestration of iron by ferritin within storage sites. Patients with inflammatory conditions may thus have restricted availability of iron for erythropoiesis and other cell functions due to increased hepcidin expression, despite normal or high levels of serumferritin. The standard threshold for iron deficiency (<30 μg/L) therefore does not apply and transferrin saturation
Elevated SerumFerritin 25138336 2014 08 25 2018 11 13 1538-3598 312 7 2014 Aug 20 JAMA JAMA Elevated serumferritin. 743-4 10.1001/jama.2014.302 VanWagner Lisa B LB Departments of Preventive Medicine and Medicine, Division of Gastroenterology & Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois. Green Richard M RM Department of Medicine, Division of Gastroenterology & Hepatology, Section of Hepatology, Northwestern University Feinberg School of Medicine, Chicago (...) , Illinois. eng F32 HL116151 HL NHLBI NIH HHS United States 1F32HL116151-01 HL NHLBI NIH HHS United States Case Reports Journal Article Research Support, N.I.H., Extramural Research Support, Non-U.S. Gov't United States JAMA 7501160 0098-7484 9007-73-2 Ferritins AIM IM JAMA. 2014 Dec 17;312(23):2572 25514310 JAMA. 2014 Dec 17;312(23):2572 25514312 Alcohol Drinking Arthritis, Reactive Biopsy Ferritinsblood Hemochromatosis complications diagnosis genetics therapy Humans Liver pathology Male Middle Aged
Estimating Iron Overload in Patients with Suspected Liver Disease and Elevated SerumFerritin Iron status evaluation in patients with suspected liver disease and elevated serumferritin is often challenging because hyperferritinemia does not always indicate iron overload. A reliable approach to estimate iron overload without exposing the patient to unnecessary investigations would help the clinician to identify patients who may take advantage of iron-removal therapy.We analyzed all liver (...) biopsies, including measurement of hepatic iron concentration, performed at the University Hospital Zurich from 1997 to 2010 to identify clinical and laboratory predictors of iron overload in patients with elevated serumferritin (n = 147).Hyperferritinemia was predictive of iron overload only in patients with a high level of serumferritin (>2000 μg/L). In patients with moderate hyperferritinemia, liver transaminases inversely correlated with hepatic iron concentration. A combination of both
Effect of sodium iron ethylenediaminetetra-acetate (NaFeEDTA) on haemoglobin and serumferritin in iron-deficient populations: a systematic review and meta-analysis of randomised and quasi-randomised controlled trials Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
for practice or further research. Funding American College of Physicians. Bibliographic details Schmitt B, Golub R M, Green R. Screening primary care patients for hereditary hemochromatosis with transferrin saturation and serumferritin level: systematic review for the American College of Physicians. Annals of Internal Medicine 2005; 143(7): 522-536 PubMedID Original Paper URL Indexing Status Subject indexing assigned by NLM MeSH Adult; Evidence-Based Medicine; Ferritins /blood; Genetic Testing (...) Screening primary care patients for hereditary hemochromatosis with transferrin saturation and serumferritin level: systematic review for the American College of Physicians Screening primary care patients for hereditary hemochromatosis with transferrin saturation and serumferritin level: systematic review for the American College of Physicians Screening primary care patients for hereditary hemochromatosis with transferrin saturation and serumferritin level: systematic review for the American
Serumferritin level predicts advanced hepatic fibrosis among U.S. patients with phenotypic hemochromatosis. DNA-based HFE gene testing can confirm hereditary hemochromatosis in most people of Northern European descent. However, liver biopsy is important to detect cirrhosis.To develop noninvasive criteria to predict the presence or absence of advanced hepatic fibrosis or cirrhosis in Americans with hemochromatosis.Cross-sectional study.Six tertiary care referral clinics.182 patients (...) with phenotypically defined hemochromatosis.Liver histopathology and serumferritin, aspartate aminotransferase, and alanine aminotransferase levels. Multivariate logistic regression analysis was used to examine factors associated with cirrhosis (defined as bridging fibrosis or unequivocal cirrhosis on biopsy).Cirrhosis was present in 40 of 182 (22%) patients in the overall group and in 35 of 147 (24%) of C282Y homozygotes. Only 1 of 93 patients with a serumferritin level less than 1000 microg/L had cirrhosis