Significance of extremely elevated ferritin level in medical inpatients
- 97 Downloads
The diagnostic and prognostic utility of extremely elevated ferritin values in hospitalized medical patients is lacking. We aimed to determine the clinical significance of ferritin levels ≥ 1000 ng/mL in adults hospitalized in the general medical service. We scanned the hospital laboratory database for ferritin values ≥ 1000 ng/mL, and evaluated the medical history, diagnoses, and survival of patients hospitalized in the general medical service. We compared the characteristics and outcomes of patients with values up-to versus above 2,999 ng/mL. Ferritin samples ranging from 1,003 to 12,170 ng/mL from 422 patients in the lower and 94 in the higher ferritin groups were included. Malignancy, repeat blood transfusions and recent chemotherapy were more prevalent in the higher ferritin group (p=0.003, p=0.002, and p<0.001, respectively). Infection (58.7%), chronic kidney disease (22.0%), and solid or hematological malignancies (21.6% and 17.1%, respectively) were the leading conditions associated with elevated ferritin. One-year survival was low, and significantly lower in patients in the higher ferritin group (10.8% vs. 16.9%, p=0.004). In conclusion, extremely elevated ferritin values in patients admitted to the general medical service are associated with multiplicity of clinical conditions and poor outcome.
KeywordsInternal Medicine Ferritin Differential Diagnosis Prognosis
Unable to display preview. Download preview PDF.
- McLaren CE, McLachlan GJ, Halliday JW, Webb SI, Leggett BA, Jazwinska EC, et al. Distribution of transferrin saturation in an Australian population: relevance to the early diagnosis of hemochromatosis. Gastroenterology. 1998 Mar;114(3):543–549. PubMed PMID: 9496946. Epub 1998/03/13. engPubMedCrossRefGoogle Scholar
- Nirel N, Rosen B, Sharon A, Blondheim O, Sherf M, Samuel H, et al. The impact of an integrated hospital-community medical information system on quality and service utilization in hospital departments. International journal of medical informatics. 2010 Sep;79(9):649–657. PubMed PMID: 20655276. Epub 2010/07/27. engPubMedCrossRefGoogle Scholar
- Song MK, Chung JS, Seol YM, Shin HJ, Choi YJ, Cho GJ. Elevation of serum ferritin is associated with the outcome of patients with newly diagnosed multiple myeloma. The Korean journal of internal medicine. 2009 Dec;24(4):368–373. PubMed PMID: 19949737. Pubmed Central PMCID: 2784982. Epub 2009/12/02. engPubMedCentralPubMedCrossRefGoogle Scholar
- Hann HW, Evans AE, Siegel SE, Wong KY, Sather H, Dalton A, et al. Prognostic importance of serum ferritin in patients with Stages III and IV neuroblastoma: the Childrens Cancer Study Group experience. Cancer research. 1985 Jun;45(6):2843–2848. PubMed PMID: 3986811. Epub 1985/06/01. engPubMedGoogle Scholar
- Bertola F, Veneri D, Bosio S, Battaglia P, Disperati A, Schiavon R. Hyperferritinaemia Without Iron Overload: Pathogenic and Therapeutic Implications Current Drug Targets-Immune, Endocrine & Metabolic Disorders. 2004;4(2):93–105Google Scholar
- Ramirez C, Rubio C, Fernandez de la Puebla RA, Aguilera C, Espejo I, Fuentes F. [Clinical significance of increased serum ferritin levels]. Medicina clinica. 2004 Apr 17;122(14):532–534. PubMed PMID: 15117645. Epub 2004/05/01. Significado clinico de los valores elevados de ferritina serica. spaPubMedGoogle Scholar