Ferritin Values In Patients Research Articles

Prognostic Value of Serum Ferritin for Patients with Severe Fever with Thrombocytopenia Syndrome: A Single-Center Retrospective Cohort Study.

This article aims to evaluate the prognostic value of ferritin in patients with severe fever with thrombocytopenia syndrome (SFTS). Patients with SFTS diagnosed at the Infection Department of Wuhan Union Medical College Hospital from July 2018 to November 2021 were included. The best cutoff value was determined by receiver-operating characteristic (ROC) curve. The survival curve was analyzed by Kaplan-Meier method and compared among different serum ferritin subgroups by log-rank test. Cox regression model was used to evaluate the effect of prognosis on overall survival (OS). A total of 229 patients with febrile thrombocytopenia syndrome were enrolled. There were 42 fatal cases, with a fatality rate of 18.3%. The best critical value of serum ferritin was 16.775mg/l. With increasing serum ferritin level, the cumulative mortality increased significantly (log-rank, P < 0.001). Cox univariate regression analysis and adjusted confounding factors such as age, viral load, liver and kidney function and blood coagulation function showed that, compared with the low ferritin group, the high ferritin group demonstrated poorer OS. The serum ferritin level before treatment can be considered a valuable index for predicting the prognosis of patients with SFTS.

Revising Ferritin Lower Limits: It's Time to Raise the Bar on Iron Deficiency.

Ferritin is a key diagnostic marker of iron deficiency (ID), but the interpretative guidance provided to physicians varies significantly. Clear discrepancies exist between clinical guidelines that recommend evidence-based ferritin cutoffs and clinical laboratories that report highly variable ferritin reference intervals (RIs) derived from apparently healthy populations. In this study, clinical laboratories across North America were surveyed to assess the RIs provided with ferritin results. Although clinical guidelines often recommend ferritin cutoffs of 15 or 30 µg/L to identify uncomplicated ID, the survey showed that 18 of 23 responding laboratories reported female RI lower limits well below 15 µg/L. To understand the clinical impact, we analyzed 52027 unique patient ferritin values over a 5-year period (2013-2017) from a tertiary care hospital. In this population, the 90th percentile ferritin cutoff to identify ID anemia in adults was 24 µg/L in female patients and 25 µg/L in male patients. Distribution of ferritin results in female patients showed that menopausal status had a significant effect on median values, which increased 2- to 3-fold in the postmenopausal state. Furthermore, sorting the data for female patients by physician specialty showed the highest prevalence of low ferritin values in patients seen in obstetrics and gynecology. This study highlights the discrepancy between clinical guidelines and clinical laboratory practice for ferritin reporting and indicates that ferritin RIs, particularly for female patients, are set to an inappropriately low threshold in most clinical laboratories in North America; this level provides good specificity but poor sensitivity when screening for ID.

The effects of iron overload, insulin resistance and oxidative stress on metabolic disorders in patients with β- thalassemia major.

Serum lipids and glycemic dysregulation are the known characteristics of β- thalassemia major (β-TM). Here, we evaluated the association of these disorders with insulin resistance (IR), oxidative stress and serum ferritin values in patients with β-TM. This case-control study was performed in thalassemia unite of Darab Hospital (Darab, Fars province, Iran) from December 2016 to December 2017. Forty-eight patients with β-TM and 33 healthy individuals were enrolled. Serum fasting blood sugar (FBS), insulin, total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL), low density lipoprotein (LDL), ischemia modified albumin (IMA), and ferritin were measured. The values of HOMA-IR, LDL: TG ratio, atherogenic index (AI), atherogenic index of plasma (AIP), and coronary risk index (CRI) were calculated. The level of serum ferritin, IMA, FBS, TG, AIP, LDL: TG ratio, and the prevalence of IR (HOMA-IR < 3.8) were significantly higher while TC, LDL-C, HDL-C, and AI were significantly lower in the patients compared to the control group. In patient with β-TM, serum ferritin revealed to have a positive association with serum insulin, HOMA-IR, AI, and CRI levels while serum IMA showed positive association with TG and AIP and inverse association with hypocholesterolemia. HOMA-IR had positive correlation with HDL levels. Oxidative stress and iron overload are predictors of serum glycemic and lipid dysregulation, suggesting possible beneficial effect of antioxidants and efficient iron chelating therapy in reducing the risk of metabolic disorders in β- thalassemia.

Iron deficiency and anemia in patients with inherited bleeding disorders

Patients with inherited bleeding disorders are predisposed to acute and chronic blood loss, which places them at high risk of iron deficiency anemia (IDA). The clinical effects of iron deficiency (ID) and IDA in the general population are significant and include low energy, reduced cardiovascular health, impaired cognition and reduced health-related quality of life. However, the incidence and impact of ID and IDA in patients with bleeding disorders is largely unknown. Here we review our approach to the diagnosis and management of iron deficiency in patients with inherited bleeding disorders. Given their risk of future iron losses, we propose more aggressive iron supplementation and higher target ferritin values in patients with ID and ongoing bleeding.

Significance of extremely elevated ferritin level in medical inpatients

Abstract 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&lt;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.

Ferritin in dialysis-related arthropathy: could it be a possible biochemical indicator of articular chronic pain?

The aim of our study was to evaluate laboratory data behaviour in two dialysis populations, with and without dialysis-related arthropathy and pain. We produced an elaboration of more than 160,000 items of biochemical data of 25 dialysis-related arthropathy patients with chronic articular pain, and 25 patients asymptomatic for joint pain and arthropathy. The pain visual analogue scale (VAS) was employed for pain intensity determination. The serum level of β-2 microglobulin was similar in the two groups of patients, while ferritin values were significantly higher in symptomatic patients. We excluded the possibility that the ferritin difference between the two groups was due to different iron storage and to an inflammatory profile. Furthermore, the pain VAS mean value was higher in patients who had higher ferritin and pain than in asymptomatic patients. It is important to underline that the higher value of ferritin in patients with chronic pain due to dialysis- -related arthropathy could represent a new stimulus for a deeper investigation of this indicator, setting a periodic revelation of pain intensity.

Prospective assessment of effects on iron-overload parameters of deferasirox therapy in patients with myelodysplastic syndromes

We report the first prospective study evaluating the effects of deferasirox on liver iron concentration (LIC), labile plasma iron (LPI) and pharmacokinetics (PK) along with serum ferritin values in patients with IPSS Low- and Intermediate-1 risk myelodysplastic syndromes (MDS) and evidence of iron overload. Twenty-four heavily transfused MDS patients were enrolled in a planned 52 weeks of therapy. PK studies showed dose-proportional total drug exposure. Data demonstrated that deferasirox was well tolerated and effectively reduced LIC, LPI and serum ferritin in the iron-overloaded patients with MDS who completed 24 and 52 weeks of therapy despite ongoing receipt of red blood cell transfusions.

Cerebrospinal fluid ferritin in patients with leukaemia and malignant lymphoma

To evaluate whether cerebrospinal fluid (CSF) ferritin could be of diagnostic value in haematological malignancies with central nervous system (CNS) involvement, the ferritin concentration was measured in 21 patients with acute leukaemia and lymphoma. Of the 17 patients without CNS involvement, 16 had CSF ferritin values in the normal range (2-7 micrograms/l); 1 patient had an elevated value, probably due to blood contamination in connection with a very high serum ferritin level. 4 patients had tumour invasion of the CNS indicated by the presence of blastic cells in the CSF; CSF ferritin levels in these patients were likewise in the normal range. There was no difference between CSF ferritin values in patients with and without CNS involvement. With the present assay, measurement of CSF ferritin appears to be irrelevant in the evaluation of CNS invasion in haematological malignancies.