Serum Ferritin Tests Research Articles

The Genetic Diagnostics of Hemochromatosis: Disparities in Low- Versus High-Income Countries.

This study provides a comprehensive overview of hereditary hemochromatosis (HH), a genetic condition characterized by iron overload due to excessive iron absorption. It elucidates diverse inheritance patterns and clinical manifestations by exploring mutations in critical genes such as HFE (hemochromatosis), HJV (hemojuvelin), HAMP (hepcidin antimicrobial peptide), TfR2 (transferrin receptor 2), and FP (ferroportin). The significance of early screening, diagnosis, and personalized management strategies based on genetic classification is emphasized, particularly in terms of high-income vs. low-income countries. Addressing challenges in diagnosis, genetic testing accessibility, and healthcare disparities, the study highlights the importance of early detection, cost-effective screening strategies, and enhancing healthcare outcomes globally. Advanced genetic testing in high-income countries facilitates early diagnosis and management, reducing complications such as liver disease and cardiomyopathy. In contrast, low-income populations face several barriers, including limited access to genetic testing, high costs, and inadequate healthcare infrastructure. Cost-effective serum ferritin (SF) and transferrin saturation (TS) tests and emerging point-of-care (POC) tests offer affordable diagnostic options for low-resource settings. Additionally, the ongoing development of hepcidin measurement methods holds promise for enhancing diagnostic capabilities. Implementing these strategies can aid healthcare providers in improving global HH management and reducing the burden of iron overload complications. Furthermore, the study underscores the need for public health initiatives to raise awareness about HH, promote routine screenings, and advocate for equitable healthcare policies. Collaborative efforts between governments, healthcare organizations, and research institutions are crucial in addressing the global burden of HH. By fostering international cooperation and resource-sharing, it is possible to bridge the gap between high-income and low-income countries, ensuring all individuals have access to the necessary diagnostic and treatment options. This holistic approach can ultimately lead to better health outcomes and improved quality of life for individuals affected by HH worldwide. This comprehensive examination of HH not only illuminates the genetic and clinical aspects of the condition but also provides a roadmap for addressing the multifaceted challenges associated with its diagnosis and management.

Clinical management of iron deficiency anemia in Japan: iron prescription patterns, treatment effectiveness, and assessments

Iron deficiency anemia is one of the most common types of anemia, but real-world clinical management practices in Japan are unclear. This study retrospectively explored iron prescription patterns, treatment effectiveness, and assessments. Patients with at least one treatment period between September 2020 and September 2022 were included and classified into three groups (ferric carboxymaltose [FCM]: 7437 patients, saccharated ferric oxide [SFO]: 98,648 patients, and oral iron: 359,547 patients). Iron-related laboratory values over time and testing proportions were evaluated. Median baseline hemoglobin levels were lowest with FCM (FCM: 8.10 g/dL, SFO: 8.70 g/dL, oral iron: 9.70 g/dL), but changes in hemoglobin levels by 12 weeks were greatest with FCM (FCM: 3.20 g/dL, SFO: 2.60 g/dL, oral iron: 1.70 g/dL). The median serum ferritin level at 8 weeks after FCM treatment was 43.70 ng/mL for ≤500 mg, versus 123.30 ng/mL for >500 to ≤1500 mg. All groups had a low proportion of serum ferritin and transferrin saturation (TSAT) testing at diagnosis (<38%), which decreased further for post-treatment assessment (<24%). This study suggests the importance of prescribing an appropriate total iron cumulative dose per the package insert, along with diagnosis and assessments based on serum ferritin/TSAT.

Association between Serum Ferritin and Prognosis in Patients with Ischemic Heart Disease in Intensive Care Units.

Recent years have seen a clear link established between elevated ferritin levels and COVID-19 prognosis. However, the impact of heightened ferritin levels on the prognosis of individuals with severe ischemic heart disease remains uncertain. We utilized the MIMIC IV database to identify a cohort of ischemic heart disease patients who underwent serum ferritin testing. We conducted regression analyses, employed the overlap propensity score weighting model, and utilized the restricted cubic splines model to comprehensively investigate the associations between serum ferritin levels and clinical outcomes. Our cohort included 1173 patients with diagnosed ischemic heart disease, categorized into high and low serum ferritin groups. After meticulous adjustment for confounding factors in a fully adjusted model, the hazard ratios (HRs) for 90-day and 1-year mortality were 1.63 (95% CI: 1.27-2.09) and 1.49 (95% CI: 1.19-1.86), respectively, in the high-ferritin group compared to the low-ferritin group. Subsequent analyses with propensity score weighting confirmed these results. Remarkably, restricted cubic spline analysis revealed an almost linear relationship between log-transformed serum ferritin levels and the risk of both 90-day and 1-year all-cause mortality. Moreover, incorporating ferritin into conventional severity of illness scores significantly improved the area under the curve for both 90-day and 1-year mortality. This study provides compelling evidence regarding the prognostic significance of serum ferritin in predicting 90-day and one-year mortality rates among patients diagnosed with ischemic heart disease.

'Ironing out the risk': Assessing the effect of plateletpheresis donation frequency on iron stores in South-Asian male donors.

Repeated blood donation is a well-known cause of iron deficiency among donors. However, present scientific literature lacks comprehensive evidence regarding the impact of regular plateletpheresis procedures on body iron reserves. In this study, we aimed to detect and correlate iron deficiency (using iron indices) with the frequency of platelet donations. Additionally, we also analysed the correlation between other iron and haematological indices with serum ferritin to determine cost-effective parameters that may serve as an initial screening approach to determine which donors should be subjected to serum ferritin testing. A total of 180 male participants from our platelet donor registry were enrolled in this observational cross-sectional study. Enrolment questionnaires were administered to eligible donors, and biological samples were collected during plateletpheresis donation. Biological tests such as complete blood count, reticulocyte indices, iron indices, vitamin B12 and folate were performed. Donors with ≥12 donations per year showed the highest prevalence of low ferritin (serum ferritin: 15-30 ng/mL) and absent iron stores (serum ferritin <15 ng/mL) (41.3% and 26.7%, respectively). Ferritin showed a significant negative correlation with recent (r = -0.346) and lifetime donations (r = -0.196). The efficacy of other indices for identifying iron depletion was much better using a serum ferritin value <15 ng/mL. Regular plateletpheresis donations can lead to varying severities of non-anaemic iron deficiency. Blood centres must regularly monitor frequent plateletpheresis donors (especially donors with more than 11 donations in a calendar year) and ideally maintain their serum ferritin above 30 ng/mL.

Hepatic Iron Deposition Quantification in Patients with β-Thalassemia Using Magnetic Resonance Imaging

Background: Detection and quantification of liver iron overload are significant to initiate treatment and monitoring of iron overload. This study aimed to quantify liver iron deposits in β-thalassemia major patients using MRI T2* and its correlation with age and heart iron deposition. Methods and Results: This retrospective study included 54 records of patients between 5-16 years of age with hepatic iron deposition due to β-thalassemia major. Data were collected from MRI reports in Picture Archiving and Communication Systems-Radiology Information System (PACS-RIS) and serum ferritin (SF) test results obtained from Hospital Information Systems and written into a dedicated datasheet. The information was recorded on a data collection sheet. The datasheet included all the required data, demographic data, lab results, T2* mapping for iron deposition in the liver and heart, and liver measurements. All subjects had high SF (from 1120 to 9850 ng/ml) with an average of 4317.93±2779.9 ng/ml. Age and SF correlated positively (r=0.368, P=0.0006). A negative correlation was observed between SF and liver T2* (r= -0578, P=0.000) (Table 3), whereas between liver T2* and heart T2* correlation had a positive direction (r= 0.329, P=0.015) Conclusion: MRI provides accurate, non-invasive, valid, and repeatable techniques, which are more acceptable to patients for assessing iron load. Furthermore, MRI T2* methods measure iron overload within the target organ precisely.

Association between serum ferritin and liver stiffness in adults aged ≥20 years: A cross-sectional study based on NHANES.

The importance of serum ferritin has been demonstrated in many liver diseases, but its relationship with liver stiffness remains unclear. The objective of this study was to investigate the association between serum ferritin levels and participants' liver stiffness measurement (LSM) in the United States population. We conducted a screening of participants from National Health and Nutrition Examination Survey (NHANES) 2017.1 to 2020.3 to ensure that participants included in this study had complete serum ferritin and LSM information. Association between the independent variable (serum ferritin) and the dependent variable (LSM) was investigated by multiple linear regression and subgroup analysis was performed to identify sensitive individuals, and we subsequently assessed whether there was a non-linear relationship between the 2 using smoothed curve fitting and threshold effect models. The final 7143 participants were included in this study. There was a positive association between participants' serum ferritin concentration and LSM, with an effect value of (β = 0.0007, 95% confidence interval (CI): 0.0002-0.0011) in the all-adjusted model. The smoothing curve and threshold effect models indicated a non-linear positive correlation between serum ferritin and LSM, which was more pronounced when serum ferritin concentration exceeded 440 ng/mL. Subsequent subgroup analysis showed that this positive correlation was more pronounced in males (β = 0.0007, 95% CI: 0.0001-0.0012), age >60 years (β = 0.00015, 95% CI: 0.0007-0.0023), black participants (β = 0.00018, 95% CI: 0.0009-0.0026), and participants with body mass index (BMI) <25 kg/m2 (β = 0.00012, 95% CI: 0.0005-0.0020). In U.S. adults, there was a positive correlation between serum ferritin levels and liver stiffness, which was more pronounced when serum ferritin exceeded 440 ng/mL. Our study suggested that regular serum ferritin testing would be beneficial in monitoring changes in liver stiffness. Male, age >60 years, black participants, and those with a BMI < 25 kg/m2 should be of greater consideration.

The effects of spirulina supplementation on serum iron and ferritin, anemia parameters, and fecal occult blood in adults with ulcerative colitis: A randomized, double-blinded, placebo-controlled trial

The present clinical trial aimed to evaluate the efficacy of spirulina administration on serum iron, ferritin, anemia parameters, and fecal occult blood test (FOBT) in adults with ulcerative colitis (UC). Eighty participants with UC were randomly assigned to take, either 1g/day (two 500mg capsules) spirulina (n=40) or placebo (n=40) in a double-blinded clinical trial for eight weeks. Dietary intake, physical activity status, serum iron and ferritin levels, anemia parameters, and FOBT were assessed in each participant at baseline and following the intervention. Seventy-three participants completed the trial. Our results indicated significantly increased (p=0.04) serum iron after eight weeks of spirulina supplementation compared to the placebo group. The spirulina group also demonstrated significantly increased mean corpuscular volume (p=0.004) whereas red blood cell count (p=0.01) and hematocrit (p=0.03) were significantly lowered in the placebo group. No significant changes in FOBT outcomes were seen between groups at baseline (p=0.12) and the end of the trial (p=0.34). Eight weeks of 1g/day spirulina supplementation improved anemia parameters in adults with UC compared to placebo. These outcomes suggest that spirulina administration may be beneficial in the management of anemia in UC. Further clinical trials of longer duration are necessary to corroborate and expand our findings. Registered at: http://www.IRCT.ir (code: IRCT20170802035460N3).

Most Reliable Haematological Indices for Diagnosis of Iron Deficiency Anaemia from Non-Iron Deficiency Anaemia in Reproductive-Age Females

Iron deficiency anaemia has become a major public health issue, especially in women of reproductive age. About 50% of anaemia is caused by iron deficiency anaemia. Numerous statistical procedures based on red blood cell parameters have been developed to easily, quickly, and inexpensively provide a differential diagnosis for the microcytic anaemia. The study aims to evaluate the reliability of the haematological discrimination indices (RBC count, Mentzer index, Red blood cell distribution width index (RDWI), Srivastava index, Green and King index, and Ehsani index) to distinguish iron deficiency anaemia from other causes of the microcytic anaemia. The blood samples were collected from non-pregnant women, and they had the microcytic anaemia. During the study, 101 blood samples were taken. A Complete blood count test and serum ferritin test were performed to calculation of the sensitivity, specificity, positive, and negative predictive value for each discrimination indices. The validity of discrimination indices was evaluated by using Youden's index. In correctly distinguishing iron deficiency anaemia from other causes of the microcytic anaemia, the Green and King index and RBC count showed the highest ability (77%) and (76%), respectively. None of the discrimination indices had 100% sensitivity or specificity. The highest and lowest sensitivity were found for the RBC count and RDWI, at 92% and 70%, respectively. The RDWI had the highest level of specificity (65%), and the Srivastava index had the lowest level of specificity (30%). The highest positive predictive value found for both Green and King, and RDWI was 78%, and the RBC count had the highest negative predictive value (78%). The Srivastava index had the lowest levels of positive and negative predictive values, 67% and 50%, respectively. According to the findings of this study, the most reliable index in the calculation of Youden's index is the Green and King index. It can be used as a pre-diagnostic tool for IDA and other causes of the microcytic anaemia

Frequency of Serum Ferritin Level in Non-Anemic Pregnant Women Presenting at Hospital

Objective: To determine mean serum ferritin level in non-anemic pregnant women presenting at Isra University Hospital during their antenatal visit. Study Design: Cross sectional study. Place and Duration: Department of Obstetrics and Gynecology at Isra University Hospital Hyderabad. January 2019-Jun 2019 Methods: A total of 78 non-anemic pregnant women with hemoglobin level&gt;11gm/dl during 1st and 3rd trimester and&gt;10.5gm/dl during 2nd trimester (as defined by CDC Criteria for anemia) were included in this study. A detailed history was obtained. All variable information was recorded in predesigned Performa. Results: The average age of women was 30.15±3.36 years. Mean serum ferritin level in non-anemic pregnant women was 13.05±5.088 nm/dl. Out of 78 cases 43(55.1%) of non-anemic female were found to have Iron deficiency state on the basis of serum ferritin estimates ≤12 ng/ml. Conclusion: In pregnancy, plasma volume, erythropoesis, and fetoplacental unit demand rise, causing iron defficiency. All pregnant women should be tested for iron status. Proper ID surveillance among pregnant women ensures accurate recording, assessment, and introduction of serum ferritin test early in the first trimester with the first ANC visit to catch afflicted pregnant. Keywords: serum ferritin, Non-anemic pregnant women, Iron deficiency anemia

Diagnostic Accuracy of complete Blood Count versus Serum Ferritin in Diagnosis of iron deficiency Anemia in Pregnant Women

Objective: To determine the frequency of confirmation of iron deficiency anemia in pregnant female on serum Ferritin who are labeled to have iron deficiency anemia on CBC in third trimester. Study Design: Cross-sectional study Study duration: October 2021 to March 2022. Setting: Department of Obstetrics &amp; Gynecology Lady Willingdon Hospital. Patients and Methods: A total of 200 patients who came to OPD were selected. Detailed history was obtained from patients and physical examination performed. CBC and serum ferritin was determined for every patient. All data was entered into the especially designed proforma. Results: Anemia was diagnosed in 74(37%) women. Highest frequency of anemia was seen in women in age group 20-30 years (33.78%), and in women with household income of Rs.15000/- to 50000/- per month. Mean hemoglobin of women was 11.41±1.05 gm. /dl. Mean MCV of women was 83.12±8.45 fl. Minimum and maximum MCV was 68 and 95 fl respectively. Mean serum ferritin level of women was 13.14±2.34 µ/l .Anemia was diagnosed in 75(37.50%) women as per complete blood count criteria. Anemia was diagnosed in 74(37%) women as per serum ferritin level criteria. Practical implication: This study will significantly contribute to the understanding and management of iron deficiency anemia in pregnant women, particularly during the third trimester. By confirming diagnoses through serum Ferritin tests in addition to complete blood count (CBC), the study can enhance the accuracy of diagnosis and treatment. Accurate detection of iron deficiency anemia will allow for more targeted and efficient treatment, thereby improving maternal and fetal health outcomes. Furthermore, this research could inform public health policies and intervention strategies aimed at preventing and managing iron deficiency anemia in pregnancy, ultimately improving the overall well-being of the community. Conclusion: Results of this study revealed that Serum ferritin level is a better diagnostic test for early detection of iron deficiency anemia in pregnant women. Keywords: Confirmation, Iron deficiency, Anemia, Pregnant, Serum Ferritin, Complete blood Count, Third trimester.

Hyperthyroidism in Sickle Cell Anaemia

Sickle cell anaemia is an excruciating disease with anaemia as a major pathological issues in the patients. Developing worlds are affected heavily by sickle cell anaemia and in malaria endemic region with high prevalent sickle cell trait. IDA and iron deficiency anaemia are common in thyroid disease and can lead to fatigue. Both hypothyroidism and hyperthyroidism can cause iron deficiency and anaemia. In turn, iron deficiency can also trigger hypothyroidism. Iron deficiency/IDA symptoms are similar to those of thyroid disease, making them hard to spot. Healthcare providers can order a blood test to check iron levels. This is called a serum ferritin test. Treatment for iron deficiency includes thyroid replacement medication, iron supplements, and/or a high-iron diet. Vitamins C, B6, B12, and others may improve iron absorption. When you have two conditions with similar symptoms, it can be hard to tell what's causing what symptoms. Pay attention to any new or worsening symptoms. Also, look at what does and doesn't improve with thyroid treatments. If you're still fatigued when your thyroid levels return to normal, talk to your doctor about the possibility of iron deficiency and IDA. Keywords: hyperthyroidism, anaemia, sickle cell, nutritional and anaemia.

Evaluation of the Serum Level of Vascular Endothelial Growth Factor in Patients with Beta-Thalassemia Major and Sickle/Beta-Thalassemia, and its Correlation with Clinical and Laboratory Parameters

BACKGROUND: The most prevalent inherited disorders of red blood cells are hemoglobinopathies, with thalassemia and sickle cell diseases (SCDs) being the most common. In SCD and thalassemia major, angiogenesis has been identified as a substantial contributor to vascular-mediated tissue damage. Vascular endothelial growth factor (VEGF) is the master regulator of angiogenesis. This study aims to assess the circulating level of serum VEGF in beta-thalassemia (β-thal) and sickle β-thal patients and also to explore the correlation with clinical and laboratory data. PATIENTS, MATERIALS AND METHODS: This is a cross-sectional study conducted on 80 individuals, clinical data were gathered, complete blood count, serum ferritin, and serum VEGF tests were done. RESULTS: Patients' age ranged from 1.5 to 17.5 years, males formed (70%). Platelet count was significantly higher in β-thal compared to sickle/β-thal (S/β-thal) patients, with a P = 0.015. Mean serum ferritin in patients was significantly higher in β-thal compared to S/β-thal patients, P &lt; 0.001. Patients' serum VEGF levels were noticeably higher than controls with P = 0.01. Strong positive correlation of serum VEGF with platelet count among the patients (r = 0.603, P &lt; 0.001). A significant positive correlation was observed between serum VEGF and the age of starting chelation therapy in thalassemic patients (r = 0.475, P = 0.006). CONCLUSIONS: Serum VEGF levels were significantly higher in patients compared to healthy controls, and there is a significant positive correlation between serum VEGF levels and the age at which iron chelation therapy was initiated as well as between serum VEGF levels and platelet counts in patients.

Features of COVID-19 in patients with chronic obstructive pulmonary disease, bronchial asthma, and cardiovascular comorbidity

Aim. The aim of the study was to identify the features of a new coronavirus infection in patients with chronic obstructive pulmonary disease (COPD), bronchial asthma (BA), and cardiovascular disease (CVD).Materials and Methods. The retrospective study included 58 patients with novel coronavirus infection, which were divided into four groups: group 1 comprised 12 patients with COPD and CVD; group 2 comprised 15 patients with BA and CVD; and group 3 comprised 31 patients with CVD only. All patients underwent a clinical examination, complete blood count, biochemical blood examination, coagulation testing, serum ferritin test, and multi-slice computed tomography.Results. The severity of dyspnea was greater in patients with COPD/CVD compared with BA/CVD, and in patients without bronchopulmonary pathology. The frequency of desaturation was the lowest in BA/CVD group compared with COPD/CVD and COPD/BA/CVD. A lower level of saturation was observed in COPD/CVD group in comparison with BA/CVD. The extent of lung damage also prevailed in group with COPD/CVD compared with patients without bronchopulmonary pathology. Patients with CVD only demonstrated the lowest level of leukocytes in contrast with all other study groups. However, the platelet count prevailed in the CVD group compared with the COPD/CVD group. Serum ferritin in patients with COPD/CVD was higher than in the AD/CVD group.Conclusion. Patients with COPD had more severe coronavirus infection due to severity of dyspnea, low saturation indicators, high values of ferritin, and greater severity of lung damage according to computed tomography. Patients with asthma were prone to a less severe course of coronavirus infection due to less dyspnea, rare episodes of desaturation, high saturation rates, and low ferritin values.

Iron Deficiency and Blood Donation: Links, Risks and Management.

The purpose of this review is to raise awareness about the frequently underappreciated association of blood donation with iron deficiency, and to describe methods for its prevention and management. Blood donors cannot expect any health benefits from the donation but have justified expectations of no harm. Iron deficiency without anemia (IDWA) and iron deficiency anemia (IDA) are common consequences of regular blood donation, and this activity is the most important factor affecting iron status in regular blood donors. Awareness of blood donation as a primary cause of sideropenia is surprisingly low among physicians. Blood donation screening identifies potential donors with IDA but is frequently inadequate to detect IDWA. For the assessment of body iron stores, plasma or serum ferritin, transferrin saturation (TSAT) and soluble transferrin receptors (sTfR) concentrations are the most widely used biochemical markers, although the percentage of hypochromic mature erythrocytes and the hemoglobin content of reticulocytes are also useful. IDWA can be prevented by limiting the total volume of blood collected, by iron deficiency screening and deferral of sideropenic donors, by prolonging the interdonation intervals, and by iron supplementation between donations. IDWA tends to be more prevalent in younger people, females, and high-intensity donors. A potentially effective strategy to address sideropenia in blood donors is serum ferritin testing, but this may lead to a higher rate of deferral. Most regular blood donors cannot replenish their iron deficit by an iron-rich diet alone and will benefit from low-dose oral iron administration with various commercially available products post-donation, a well-tolerated strategy. However, valid concerns exist regarding the possibility of worsening the iron overload in donors with undiagnosed hemochromatosis or masking the symptoms of a clinically important gastrointestinal hemorrhage or other underlying medical condition. Finally, educational efforts should be intensified to improve the awareness of blood donation as a primary cause of iron deficiency among physicians of all specialties.

Biochemical assessment of renal function and its correlation with iron overloading in different variants of thalassemia

Thalassemia is a hereditary disorder characterised by changes in organ function and iron overload resulting from multiple blood transfusions, inefficient erythropoiesis, and increased gastrointestinal iron absorption. This study aimed to compare and correlate renal function tests with blood transfusion frequency, annual blood requirement, and ferritin levels in patients with Thalassemia Major, Intermedia, and Minor. Fifty blood samples were collected from each clinically diagnosed patient with thalassemia major, intermedia, and minor at MGM Hospital in Navi Mumbai for complete blood count estimates, serum ferritin, and renal function tests. The frequency of blood transfusions and the annual blood requirement was recorded. The Pearson correlation coefficient was used to examine the relationship. SPSS Software was used to tabulate and process patient data. A p-value of less than 0.001 was regarded as significant. This study included both male (64) and female (84) participants. The major, intermedia, and minor serum ferritin levels were 2212.5 ug/L, 1643 ug/L, and 53.55 ug/L, respectively. Serum creatinine and sodium levels in thalassemia major (27.41 ± 5.31umol/L, 128.02± 4.56 mmol/L, respectively) and intermedia (36.25 ± 6.19 umol/L, 128.96± 4.39 mmol/L respectively) decreased as the frequency of transfusion and serum ferritin level increased. Uric acid levels (361.64 ± 64.83 umol/L) were higher in patients with thalassemia intermedia. Transfusion therapy, required for Major and Intermedia, increases iron overload, which harms organ function and quality of life. Early detection and genetic counselling are necessary for proper thalassemia management.

Monitoring iron stores in Icelandic blood donors from 1997 through 2019.

To estimate the frequency of iron deficiency (ID) and anaemia in blood donors in Iceland and the impact of serum ferritin (SF) testing policy change. Blood donations contribute to ID and/or anaemia in whole blood donors (WBD). SF may be used to monitor blood donor iron stores. The study included WBD and new donors (ND) in the Icelandic Blood Bank in 1997-2019. SF was measured for ND and intermittently for WBD until October 2017, but thereafter for all WBD and ND at every visit. In January 2018, the SF threshold increased from 14 to 16 μg/L for ND and from 8 to 10μg/L for WBD. The study included 85 370 SF results from 243 369 visits of 32 910 donors. Median SF was higher for males than females, both for ND (88.0 vs. 31.2 μg/L, p < 0.001) and WBD (before 2018: 43.0 vs. 22.0 μg/L, p < 0.001). After the policy change in 2018, median SF increased for both male WBD (to 45.2μg/L, p < 0.001) and female WBD (to 25.7μg/L, p < 0.001). ID (SF <15 μg/L) was present in 10.6% of female ND and 0.5% of male ND. After policy change, the proportion of WB donations associated with ID decreased for males (from 6.4% to 4.0%) and females (from 18.9% to 14.1%). ID anaemia was present at some time in 3.7% of female WBD and 1.2% of male WBD. This nationwide study showed that ID in WB donors is common, especially among females, but monitoring SF may improve donor management.

An Analytical Study of Serum Ferritin, Vitamin D, and Thyroid Function in Females with Diffuse Hair Loss

Objective: Women with diffuse hair loss need to be screened for possible causes or factors responsible for increased hair shedding and also to exclude factors that can increase hair shedding and aggravate the disease. Material and Methods: A prospective cross-sectional study of 40 cases (18–45years) of diffuse hair loss and 40 healthy females were included. The diagnosis was based on the detailed history, clinical examination to rule out pattern hair loss, and hair pull test. Complete hemogram, serum ferritin, vitamin D, and thyroid function tests (T3, T4, thyroid-stimulating hormone [TSH]) along with all routine investigations were determined for each participant. A diet history of vegetarians and non-vegetarians was also taken. Results: On screening, serum ferritin in cases ranged from 3.92 to 104 ng/mL with a mean of 22.36±23.10 ng/mL and that in controls ranged from 5.5 to115 ng/mL with a mean of 29.97±45.72 ng/mL. The serum ferritin level in cases was lower, at a cut-off value of 10 ng/mL, which is statistically significant (p= 0.027). For those with serum ferritin level &gt;10 ng/mL, the mean concentration of hemoglobin was 11.65 ± 0.79 gm%, whereas for the &lt;10 ng/mL serum ferritin level, the mean concentration of hemoglobin was 11 ± 1.1 gm% with a significant statistical difference (p= 0.027). The serum level of vitamin D in cases ranged from 8 to 57.4 IU/dL with a mean of 20.24±11.98 IU/dL while that in controls ranged from 11.1 to 42.6 IU/dL with a mean of 22.42±9.29 IU/dL, which was statistically significant difference (p= 0.003). We found no association of thyroid dysfunction with diffuse hair loss. On dietary evaluation, significant statistical association among vegetarians (67.5% cases and 40% controls) and non-vegetarians (32.5% cases and 60% controls) was observed (p= 0.024); however, we could not find any statistical significant association of diet with ferritin and vitamin D. Conclusion: Low ferritin and vitamin D may contribute to diffuse hair loss.

Cutoff Values for Serum Ferritin in Predicting Cirrhosis Severity due to Cholestatic Jaundice in Vietnamese Children.

Background:High serum ferritin levels are associated with liver cirrhosis severity and worse outcomes for hepatopathies. This study determined the serum ferritin cutoff values for predicting cirrhosis severity in children with cholestatic jaundice.Methods:A retrospective study was performed, including all cases diagnosed with cirrhosis in children aged 1 month to 16 years at Children’s Hospital 2-Vietnam between 2016 and 2021. Receiver operating characteristic (ROC) curve analysis was used to estimate ferritin cutoff values for predicting disease severity.Results:The study included 95 patients with cirrhosis due to cholestatic jaundice. Decompensated cirrhosis accounted for the majority (74.7%) of cases. Increased serum ferritin concentrations predicted cirrhosis severity in children, and the optimal ferritin cutoff value for predicting decompensated cirrhosis was determined to be 195 μg/l, resulting in a sensitivity of 65.22%, a specificity of 95.83%, and an area under the ROC curve (AUC) or 0.82. The Child–Pugh C group had higher ferritin levels than the Child–Pugh A and B group (p < 0.001), and the ferritin cutoff value for distinguishing between Child–Pugh classifications was 195 μg/l, resulting in a sensitivity of 71.2%, a specificity of 87.9%, and an AUC of 0.80.Conclusions:Serum ferritin levels are significantly associated with decompensated cirrhosis and disease severity (as assessed by Child–Pugh score). Routine serum ferritin testing may contribute to predicting cirrhosis severity in children.

Serum Ferritin and its Importance for SARS-CoV-2-Infected Patients.

Serum ferritin is an acute-phase protein whose level is increased in several inflammatory diseases. This review describes the structure and function of ferritin as well as its association with the prognosis of patients with COVID-19. We searched MEDLINE/PubMed databases, Scopus, and Web of Science for prospective and review articles that examined ferritin and its association with COVID-19 severity. Based on all these articles and clinical experience, a review was constructed and full texts of the articles that were retrieved were accessed. All COVID-19 related studies conducted in 2020, which performed serum ferritin testing, clearly showed ferritin as a biomarker of COVID-19 severity in hospitalized patients. Ferritin levels in severe patients were significantly increased relative to those in non-severe patients (p < 0.001). Non-survivors had significantly higher ferritin levels than the survivors (p < 0.001). Determination of ferritin levels was specific and sensitive for early disease severity prediction in patients with COVID-19. Serum ferritin can also be used for predicting the response to COVID-19 vaccines.

Evaluation of hyperferritinemia causes in rheumatology practice: a retrospective, single-center experience.

Hyperferritinemia may develop due to various reasons such as inflammation, infection, or malignancy. The purpose of the study to explore the prevalence and to figure out the causes of general hyperferritinemia and extreme hyperferritinemia as detected through the ferritin measurements requested by the rheumatology department. Adult patients at the age of 18 years and older with at least one serum ferritin level measurement at or above 500 ng/mL as requested by the rheumatology department between January 2010 and December 2019 were evaluated retrospectively. Hyperferritinemia was detected in 4.7% of 11,498 serum ferritin tests. The mean age of 242 patients found to have hyperferritinemia was 53.7 ± 17.1 years; of the patients, 63.2% were female, and the mean serum ferritin value was 2820 ± 5080 ng/mL. The most common cause of hyperferritinemia was rheumatological diseases with a ratio of 59.1%, which was followed by infections, iron overload, and solid malignancy. Among the rheumatologic diseases, adult-onset Still’s disease (AOSD), rheumatoid arthritis, and vasculitis were the cause accounting for hyperferritinemia. Ferritin levels were significantly higher in the AOSD group compared to the other rheumatologic disease groups (p < 0.0001). While extreme hyperferritinemia (ferritin ≥ 10,000 ng/mL) rate in our cohort was 0.2%, the most common cause was AOSD (15/17). In patients with hyperferritinemia, 3 month mortality was found to be 8.7%. CRP level was identified as the only independent predictor for the 3 month mortality in all patients [OR 1.088 (95% CI 1.004–1.178), p = 0.039]. Although rheumatologic disease activation and infections are the most common causes, the other causes should also be considered for the differential diagnosis.