Document 0409
 DOCN  M9590409
 TI    Extremely elevated serum ferritin levels in a university hospital:
       associated diseases and clinical significance.
 DT    9509
 AU    Lee MH; Means RT Jr; Diagnostic Hematology Laboratory, University of
       Cincinnati; College of Medicine, Ohio 45267-0562, USA.
 SO    Am J Med. 1995 Jun;98(6):566-71. Unique Identifier : AIDSLINE
       MED/95297476
 AB    PURPOSE: To establish the frequency with which serum ferritin levels >
       or = 1,000 ng/mL occur in a general hospital population, and to
       determine the clinical significance of this finding. PATIENTS AND
       METHODS: All serum ferritin determinations performed between June 1992
       and July 1993 at the University of Cincinnati Medical Center were
       reviewed and patients with serum ferritin levels > or = 1,000 ng/mL
       identified. The medical records of these patients were then reviewed.
       RESULTS: Of 1,826 serum ferritin determinations performed during the
       study period, 122 (6.7%) were > or = 1,000 ng/mL. Associated clinical
       syndromes found in the 95 patients with serum ferritin > or = 1,000
       ng/mL included liver disease (20.0%), renal disease (17.9%), malignant
       disease (17.9%), human immunodeficiency virus (HIV) infection (16.8%),
       non-HIV systemic infections (15.8%), chronic transfusions (10.5%), and
       sickle cell syndromes (10.5%). No syndrome usually associated with
       extreme serum ferritin elevations was identified in 8.4% of patients,
       and 16.8% of the patients fell into more than one category. The highest
       mean serum ferritin levels occurred in the chronically transfused and
       sickle cell groups. Concomitant serum transferrin saturation values were
       determined with 82 (86.3%) of the elevated serum ferritin levels and did
       not correlate well with them. The highest mean transferrin saturation
       levels occurred in the liver disease group. Transferrin saturation > or
       = 50%, suggestive of iron overload, was significantly more frequent in
       the liver disease group (P = 0.002); and saturation < or = 15%,
       suggestive of iron-deficient erythropoiesis, was significantly more
       frequent in the HIV group (P = 0.001). CONCLUSION: Outside the setting
       of clinical syndromes associated with iron overload (liver disease,
       transfusions, sickle cell syndromes), serum ferritin levels > or = 1,000
       ng/mL serve as a nonspecific marker for a variety of significant
       disorders, including infectious and neoplastic diseases. Further study
       of the regulation of ferritin production may provide insight into the
       pathogenesis of disorders associated with extreme serum ferritin
       elevations.
 DE    Blood Chemical Analysis  Ferritin/*BLOOD  Hospitals, University  Human
       Predictive Value of Tests  JOURNAL ARTICLE

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