Hearnshaw S, Thompson NP, McGill A. The epidemiology of hyperferritinaemia. World J Gastroenterol 2006; 12(36): 5866-5869 [PMID: 17007054 DOI: 10.3748/wjg.v12.i36.5866]
Corresponding Author of This Article
Dr Sarah Hearnshaw, Department of Gastroenterology, the Freeman Hospital, High Heaton, Newcastle upon Tyne, Tyne and Wear, NE7 7DN, United Kingdom. sarahhearnshaw@hotmail.com
Article-Type of This Article
Rapid Communication
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World J Gastroenterol. Sep 28, 2006; 12(36): 5866-5869 Published online Sep 28, 2006. doi: 10.3748/wjg.v12.i36.5866
Table 1 Conditions associated with raised ferritin and diagnostic criteria used
Condition
Requirements for diagnosis
Hereditary haemochromatosis
Genotyped and / or biopsy proven
Renal failure
Dialysis dependent
Alcoholic liver disease (ALD)
Liver biopsy or Liver Function Test (LFT) abnormality compatible with ALD in patients with history of alcohol excess (> 30 u/wk) in whom other causes have been excluded
Inflammatory disease
Raised C-Reactive Protein (CRP) and/or Erythrocyte Sedimentation Rate (ESR) on more than one consecutive test and recognised active inflammatory disease
Repeated blood transfusion
More than 4 unit packed cell transfusion in preceding 6 mo
Autoimmune disease
Recognised autoimmune disease with positive auto-antibody test
Other liver disease
All other recognised causes of parenchymal liver damage with abnormal LFTs, excluding ALD and HHC
Haematological disease
Bone marrow or blood film proven primary haematological disorder
Neoplasia
Histologically proven neoplastic disease
Weight loss
More than 10% body mass (kg) lost in preceding six months
Human immuno-deficiency virus (HIV)
Positive HIV test
Table 2 Causes of ferritin ≥ 1500 mg /L in local and general population
Condition
All patients, n = 150 (% total)
Local patients, n = 71 (% total)
Number with condition as singlecause for raised ferritin (%)
HHC
13 (8.6)
8 (11.3)
5/13 (38.5)
Alcoholic liver disease
33 (22)
22 (31.0)
24/33 (72.7)
Other liver disease
20 (13.3)
10 (14.1)
8/20 (40.0)
Inflammatory Disease
28 (18.6)
9 (12.6)
7/28 (25.0)
Neoplasia
29 (19.3)
11 (15.4)
6/29 (20.7)
Repeated blood transfusion
26 (17.3)
9 (12.6)
1/26 (3.8)
Autoimmune disease
21 (14.0)
8 (11.3)
2/21 (9.5)
Haematological disease
38 (25.3)
11 (15.4)
6/38 (15.7)
Renal failure
42 (28.0)
15 (21.1)
20/42 (47..6)
Weight loss
17 (11.3)
6 (8.4)
2/17 (11.7)
HIV
1 (0.7)
1 (1.4)
0/1 (0)
Unexplained
3 (2.0)
3 (4.2)
3/3 (100)
Table 3 The most common causes of hyperferritinaemia
All patients (%)
Local Patients (%)
Renal failure (28.0)
Alcoholic liver disease (31.0)
Haematological disease (25.3)
Renal failure (21.1)
Alcoholic liver disease (22)
Neoplasia (15.4)
Neoplasia (19.3)
Haematological disease (15.4)
Inflammatory disease (18.6)
Other liver disease (14.1)
Repeated blood transfusion (17.3)
Repeated blood transfusion (12.6)
Autoimmune disease (14.0)
Inflammatory disease (12.6)
Other liver disease (13.3)
HHC (11.4)
Weight loss (11.3)
Autoimmune disease (11.4)
HHC (8.6)
Weight loss (8.4)
Unexplained (2.0)
Unexplained (4.2)
HIV (0.7)
HIV (1.4)
Table 4 Median ferritin levels in each condition
Condition (n)
Median ferritinμg/L
Number with condition as single identifiable cause for ferritin≥ 1500μg/L
Median ferritin in those with = cause for ferritin≥ 1500μg/L
HHC (13)
5031
5
7432
Other liver disease (19)
2889
8
3055
Unexplained (3)
2606
n/a
n/a
Weight loss (16)
2508
2
2160
ALD (31)
2484
24
2121
Autoimmune disease (21)
2203
2
2017
Haematological disease (31)
2075
5
3974
Inflammatory disease (24)
1995
3
2877
Repeated blood transfusion (29)
1977
1
6315
Renal failure (40)
1975
20
1954
Neoplasia (26)
1767
3
2409
HIV (1)
1711
0
n/a
Citation: Hearnshaw S, Thompson NP, McGill A. The epidemiology of hyperferritinaemia. World J Gastroenterol 2006; 12(36): 5866-5869