Conditions associated with extreme hyperferritinemia (> 3000 μg/L) in adults.
Intern Med J. 2015 Apr 8;
Authors: Wormsbecker AJ, Sweet DD, Mann SL, Wang SY, Pudek MR, Chen LY
BACKGROUND: The clinical significance of extreme hyperferritinemia has come under scrutiny with the increasing recognition of Hemophagocytic lymphohistiocytosis (HLH) in adults. Most studies of hyperferritinemia have focused on serum ferritin >1000 μg/L, often in ambulatory patients. The conditions associated with more extreme hyperferritinemia are poorly understood.
AIMS: To examine conditions associated with extreme hyperferritinemia >3000 μg/L in acutely ill adults at a quaternary care hospital.
METHODS: Patients with serum ferritin >3000 μg/L at Vancouver General Hospital between August 1, 2011 and August 1, 2012 were identified. Those over 18 years of age and with clinical data available were included in the study.
RESULTS: 83 subjects were identified. 21 cases (25%) were due to transfusional iron overload, 16 (19%) due to liver disease, and 15 cases (18%) were due to mixed factors. Hemophagocytic lymphohistiocytosis (HLH) was diagnosed in 6 of 83 patients (7%) with ferritin >3000 μg/L, but 6 of 8 patients (75%) with ferritin >20 000 μg/L.
CONCLUSIONS: Extreme hyperferritinemia >3000 μg/L is uncommon in adult patients. The highest serum ferritin values are seen in HLH, but the differential diagnosis for serum ferritin >3000 μg/L remains broad with iron overload and liver disease being the most common causes.
PMID: 25851400 [PubMed - as supplied by publisher]