scholarly journals Elevated serum ferritin level effectively discriminates severity illness and liver injury of coronavirus disease 2019 pneumonia

Biomarkers ◽  
2020 ◽  
pp. 1-18 ◽  
Author(s):  
Peng Cao ◽  
Yuanjue Wu ◽  
Sanlan Wu ◽  
Tingting Wu ◽  
Qilin Zhang ◽  
...  
Keyword(s):  
Liver Injury ◽  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Elevated Serum

Elevated Serum Ferritin Levels Are Highly Associated with Diabetes Mellitus and Hypothyroidism in Thalassemia Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 5174-5174
Author(s):  
Sasinee Hantrakool ◽  
Adisak Tantiworawit ◽  
Ekarat Rattarittamrong ◽  
Chatree Chai-adisaksopa ◽  
Weerasak Nawarawong ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Iron Overload ◽  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Elevated Serum ◽  
Major Risk Factor ◽  
Maximum Serum ◽  
Hemoglobin E

Abstract Abstract 5174 Background: Endocrinopathiesare well recognized serious complications in thalassemia patients with iron overload. Elevated serum ferritin levels reflect severity of iron overload and are associated with relevant clinical outcomes. Increased serum ferritin > 2, 500 μg/dl has been found to predict the development of cardiac function abnormalities but the predicting serum ferritin level for diabetes and hypothyroidism has not been determined. Method: This is a cross sectional and retrospective study to evaluate the correlation between ferritin levels and endocrinopathies (diabetes, hypothyroidism) in thalassemia patients. All thalassemia patients age > 18 years old, during August 2011 and June 2012 were enrolled. The diagnosis and type of thalassemia were reviewed and confirmed. Diabetes and hypothyroidism were diagnosed by fasting blood sugar and thyroid functions test. Serum ferritin was measured at the same period. The medical record was reviewed for age, sex, splenomegaly, history of splenectomy, transfusion requirement, maximum serum ferritin level, mean serum ferritin level and iron chelation history. Result: Among 92 thalassemia patients [35 male (38%) and 57 female (62%)] with a median age of 30. 6 years (range, 18–71). There were 28 (30. 4%) cases of Homozygous β-thalassemia, 45 cases (48. 9%) of β-thalassemia/Hemoglobin E and 18 cases (19. 5%) of Hemoglobin H or AE Bart's disease. Most patients (60. 9%) underwent splenectomy, while only one third of patients (34. 8%) were NTDT (non-transfusion dependent thalassemia) (Table 1). The mean value of random and maximum serum ferritin levels for the whole group were 2, 408 μg/dl (range279–9, 817) and 5, 101 μg/dl (range 279–37, 656), respectively. The prevalence of diabetes mellitus and impaired fasting glucose (IFG) were 9. 8% (9 cases) and 10. 9% (10 cases), respectively. Patients with diabetes had significantly higher mean maximum serum ferritin levels than those with non-diabetes (11, 241 μg/dl vs. 4, 468 μg/dl, (p=0. 0001) (Table 2). The cut-off point of maximum serum ferritin levels > 2, 500 μg/dl was the major risk factor for the development of diabetes complication in this group of patients. Six patients (6. 5%) and 21 patients (22. 8%) had hypothyroidism and subclinical hypothyroidism, respectively. Patients with hypothyroidism had significantly higher mean maximum serum ferritin levels than those with euthyroidism [(7, 638 vs. 4, 117 μg/dl, (p=0. 003)]. From univariate analysis, the cut-off point of maximum serum ferritin levels > 3, 500 μg/dl was the major risk factor associated with hypothyroidism (p=0. 007). Conclusion: Elevated serum ferritin level is a predictor of the development of diabetes mellitus and hypothyroidism in thalassemia patients with iron overload. The maximum serum ferritin levels of greater than 2, 500 and 3, 500 μg/dl are associated with diabetes mellitus and hypothyroidism, respectively. These findings warrant the value of iron chelating therapy to maintain serum ferritin levels below 2, 500 μg/dl to avoid the development of endocrinopathies in patients with thalassemia. Disclosures: No relevant conflicts of interest to declare.

Elevated serum ferritin level with cataract of spectacular morphology: Hyperferritinemia-cataract syndrome

2019 ◽  
Vol 36 (6) ◽  
pp. 390-393
Author(s):  
Deniz Aslan ◽  
Rüştü Fikret Akata ◽  
Hatice Tuba Atalay ◽  
Ahmet Yücel Üçgül
Keyword(s):  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Elevated Serum

scholarly journals Elevated Serum Ferritin Level Is Associated with the Incident Type 2 Diabetes in Healthy Korean Men: A 4 Year Longitudinal Study

PLoS ONE ◽  
2013 ◽  
Vol 8 (9) ◽  
pp. e75250 ◽  
Author(s):  
Chang Hee Jung ◽  
Min Jung Lee ◽  
Jenie Yoonoo Hwang ◽  
Jung Eun Jang ◽  
Jaechan Leem ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Longitudinal Study ◽  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Elevated Serum ◽  
Incident Type ◽  
Incident Type 2 Diabetes

scholarly journals Elevated serum ferritin levels in the pediatric intensive care unit

2019 ◽  
Vol 2 (3) ◽  
pp. 19
Author(s):  
Suzie Lee ◽  
Marinka Twilt ◽  
Simon J Parsons
Keyword(s):  
Intensive Care Unit ◽  
At Risk ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Elevated Serum ◽  
Pediatric Intensive Care ◽  
Mortality And Morbidity

Background:   Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening inflammatory condition caused by dysregulation of the immune system. HLH can develop in children with a variety of underlying causes including genetic cause, infection, autoimmune diseases, malignancy, etc. The symptoms of HLH are often similar to other conditions such as bacterial sepsis or systemic inflammatory response syndrome. This is a problem as the similarities among those different diseases make it difficult for the doctors to diagnose HLH and this can possibly lead to a delay in treatment. 50-75% mortality is reported in patients with secondary HLH (non-inherited) who do not receive treatment. Elevated serum ferritin level, referred to as hyperferritinemia, is the most characteristic feature of HLH and may be helpful in diagnosing HLH apart from other illnesses. This research investigates the incidences of patients with elevated serum ferritin level at the pediatric intensive care unit (PICU) of Alberta Children’s Hospital from 2014-2018 to gain a better understanding of HLH and hyperferritinemia.   Objectives:   The objectives of the study are i. identify diseases associated with hyperferritinemia on the PICU; ii. predict which PICU patient with hyperferritinemia is at risk to develop HLH during PICU admission; and iii. determine mortality risk in patients with hyperferritinemia and HLH at the PICU. Methods: This project is a retrospective chart review. A literature review was performed on the topic of hyperferritinemia and HLH, and relevant variables were identified for creating a Redcap database. Patient charts and medical records were examined for data collection of different elements including diagnosis, laboratory values, treatments, and survival status. Data of 91 patients who presented with hyperferritinemia in PICU from 2014 to 2018 is being examined. Results: Although this study is currently in progress, it is anticipated to provide insight into the features associated with hyperferritinemia and determine patients with hyperferritinemia who are at risk of developing HLH. Conclusion: Overall, the findings from this study may contribute to better understanding of hyperferritinemia and HLH in pediatric patients and contribute to decreasing mortality and morbidity of patients with hyperferritinemia and HLH.  

Toll-Like-Receptor Expression and Cellular Immune Reconstitution In AML-Patients with Elevated Serum Ferritin Levels After Allogeneic transplant.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1049-1049 ◽  
Author(s):  
Ahmet Elmaagacli ◽  
Nina Steckel ◽  
Michael Koldehoff ◽  
Sandra Christoph ◽  
Hellmut Ottinger ◽  
...  
Keyword(s):  
Serum Ferritin ◽  
Innate Immune System ◽  
Immune Reconstitution ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Elevated Serum ◽  
Innate Immune ◽  
Tlr9 Expression ◽  
Post Transplant ◽  
Cellular Immune

Abstract Abstract 1049 Elevated pretransplant serum ferritin levels have been associated with an increased susceptibility for opportunistic infections and increased incidence of morbidity and mortality after allogeneic haematopoietic stem cell transplantation (HCT). We studied in 81 patients who underwent myeloablative allogeneic HCT for acute myeloid leukemia pre- and posttransplant serum ferritin levels and correlated the serum ferritin levels with the TLR9 expression and the cellular immune reconstitution 3 and 12 months post transplant. Further, we studied in vitro-experiments in Kasumi-1 cells the TLR1, TLR2, TLR3, TLR5, TLR7, TLR9 and TLR10 expression after overwhelming iron and ferritin exposure. The average pretransplant serum ferritin level was 1245 μg/ml (mean) in all AML-patients (mean 1100μg/l for patients with AML in 1.CR and mean 1820μg/l for patients with AML > 1.CR). Post transplant serum ferritin level increased up to 2080 μg/ml (mean) for all AML patients (mean 1290mg/l for AML in 1.CR and mean 2350 μg/l for patients with AML > 1.CR). The application of 300ng iron to acute leukaemia cell lines SD1, and Kasumi-1 cells increased significantly TLR1, TLR2, TLR3, TLR5, TLR7 and TLR9 expression in relation to the housekeeping gene abl measured by real-time RT-PCR. In Kasumi-1 cells TLR1 increased up to 50,6% (p=0.014) TLR2 up to 35.5% (p=0.046), TLR3 up to 57,8% (p=0.006), TLR5 up to 62.9% (p=0.005), TLR7 up to 46.2% (p=0.02), TLR9 up to 44.2%(p=0.026) and TLR10 up to 54,7% (p=0.07) compared to untreated Kasumi-1 cells. The application of 2000μg/L ferritin increased TLR9 expression even more extensively in Kasumi-1 cells: TLR1 increased up to 332% (p<0.001), TLR2 up to 150% (p=0.016), TLR3 up to 293% (p<0.0001), TLR5 up to 349% (p<0.0001), TLR7 up to 287% (p<0.0001), TLR9 up to 229% (p=0.028). Elevated TLR-expression was also seen in CD34+ progenitor cells derived from volunteers. Further, patients with elevated post transplant ferritin level > 2000 μg/l had an increased TLR9 expression in mononuclear cells (TLR9/ABL quotient 6485 versus 4543; p<0.05) 3 months post transplant. The numbers of T helper cells (mean 412 versus 231 cells/μl 3 months post transplant, p=0.014), and cytotoxic T cells CD4+CD8+ in patients with elevated serum ferritin level were significantly elevated after transplant (mean 285 versus 164 cells/μl 3 months post transplant, p=0.027), whereas no differences were found in the number of B19+ cells and Nk cells. These results indicate that elevated ferritin levels might activate the innate immune system by increasing TLR expression. This might be of importance since we recently showed that increased TLR9 expression was associated with adverse impact on non-relapse mortality in the transplant setting. Further exaggerated TLR9 expression has been discussed to induce overwhelming immune responses as SIRS or ARDS. More studies are definitely necessary to evaluate the role of elevated iron overload on the innate immune system. Disclosures: No relevant conflicts of interest to declare.

scholarly journals HFEMutations in Caucasian Participants of the Hemochromatosis and Iron Overload Screening Study with Serum Ferritin Level <1000 μg/L

2013 ◽  
Vol 27 (7) ◽  
pp. 390-392 ◽  
Author(s):  
Paul C Adams ◽  
Christine E McLaren ◽  
Mark Speechley ◽  
Gordon D McLaren ◽  
James C Barton ◽  
...  
Keyword(s):  
Iron Overload ◽  
Serum Ferritin ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Transferrin Saturation ◽  
Elevated Serum ◽  
Population Based ◽  
Ferritin Concentration ◽  
Post Test ◽  
Screening Study

BACKGROUND: Many patients referred for an elevated serum ferritin level <1000 μg/L are advised that they likely have iron overload and hemochromatosis.AIMS: To determine the prevalence ofHFEmutations in the hemochromatosis gene for 11 serum ferritin concentration intervals from 200 μg/L to 1000 μg/L in Caucasian participants in a primary care, population-based study.METHODS: The Hemochromatosis and Iron Overload Screening study screened 99,711 participants for serum ferritin levels, transferrin saturation and genetic testing for the C282Y and H63D mutations of theHFEgene. This analysis was confined to 17,160 male and 27,465 female Caucasian participants because theHFEC282Y mutation is rare in other races. Post-test likelihood was calculated for prediction of C282Y homozygosity from a ferritin interval. A subgroup analysis was performed in participants with both an elevated serum ferritin level and transferrin saturation.RESULTS: There were 3359 male and 2416 female participants with an elevated serum ferritin level (200 μg/L to 1000 μg/L for women, 300 μg/L to 1000 μg/L for men). There were 69 male (2.1%) and 87 female (3.6%) C282Y homozygotes, and the probability of being a homozygote increased as the ferritin level increased. Post-test likelihood values were 0.3% to 16% in men and 0.3% to 30.4% in women.CONCLUSIONS: Iron loadingHFEmutations are unlikely to be the most common cause of an elevated serum ferritin level in patients with mild hyperferritinemia. Patients should be advised that there are many causes of an elevated serum ferritin level including iron overload.

scholarly journals Elevated Ferritin Predicts for Inferior Survival in Patients with Acute Leukemia and May be an Early Marker of a Underlying Systemic Pathologic Inflammation

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 2791-2791 ◽  
Author(s):  
Preetesh Jain ◽  
Kelly Casteel ◽  
Carl E. Allen ◽  
Kenneth L. McClain ◽  
Sa Wang ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Serum Ferritin ◽  
Research Funding ◽  
Serum Ferritin Level ◽  
Ferritin Level ◽  
Elevated Serum ◽  
Prior Treatment ◽  
Complex Karyotype ◽  
Risk Of Death ◽  
Increased Risk

Abstract Introduction: The prognostic role of serum ferritin in adult patients (pts) with newly diagnosed and/or relapsed acute leukemia remains undefined. Significantly elevated serum ferritin level (>5,000 or >10,000) was a sensitive and specific for hemophagocytic lymphohistiocytosis (HLH). The outcome of adults with malignancy-associated HLH (M-HLH) is dismal (Tamamyam et al., Cancer 2016). Early diagnosis and timely therapy in these critically ill pts may be delayed while waiting for specialized labs such as IL-2Rα. We hypothesized that elevated serum ferritin might be prognostic in adult pts with acute leukemia and may serve as a rapid marker for a systemic cytokine process. Methods: 1819 pts with AML and 260 pts with ALL evaluated at our institution between Jan 2010 to Jan 2016 with a serum ferritin level within 30-days of initial presentation were reviewed. Survival was calculated from the date of ferritin testing. Kaplan-Meier product limit method was used to estimate the median overall survival (OS) and Cox proportional hazard models were used to model the association between survival and risks factors. Recursive partitioning (RP) was used to identify optimal cut-off of ferritin levels. Results: In the 1819 pts with AML, median (med) age was 63 years, 57% males, the med ferritin value was 1,276 ng/ml (range, 4 - 68,262). Fifty% (n=904) pts were previously untreated. AML pts with high ferritin had significantly higher WBC count, lower platelet count, lower albumin, and high LDH (P<0.05 in each) and these remained significant when only previously untreated pts were analysed. Higher prevalence of complex karyotype, prior treatment, FLT3 and NPM1 mutations were seen in pts with high ferritin and only NPM1 remained significant when previously untreated pts were analyzed. Overall pts with AML with ferritin ≥5,000 had a significantly inferior med OS (5.1 vs 11.6 months; P<0.001) (Figure 1A). The med OS remained inferior in previously untreated pts with AML with ferritin ≥5,000 (6.6 vs 16.3 months, P=0.002) (Figure 1B). By RP analysis we found an optimal cut-off of < or ≥ 1827 ng/ml which discriminated survival in all pts with AML (Figure 1C) and < or ≥ 903 when only previously untreated pts with AML were considered. Ferritin ≥ 1827 significantly predicted for increased risk of death in MVA [HR 95% CI 1.29 (1.03-1.62) (p=0.03)] along with complex karyotype, lower hemoglobin, prior treatment, and low prevalence of CBF-AML when all AML pts were analysed. In untreated AML pts, a level of ≥ 903 predicted for increased risk of death in univariate but not in MVA. In ALL pts (n=260), the med ferritin was 1081 ng/ml (range 20-72,060). Overall ALL pts with ferritin ≥5,000 (n=28) vs with <5000 (n=232) had significantly higher prevalence of elevated LDH, complex karyotype, and prior therapy, while in previously untreated pts with ferritin ≥5,000 (n=8 vs n=177) only elevated LDH was significant. Pts with ferritin ≥5,000 had significantly inferior med OS when all pts were included (Figure 1D), however in previously untreated pts, the difference was not significant (Figure 1E). By RP analysis, ferritin levels ≥ 3015 significantly predicted for increased risk of death in MVA [HR 95% CI 2.51 (1.57-4.02) (p<0.001)] (Figure 1F) along with prior treatment, high % of BM blasts and low albumin levels in all pts. No cut off could be identified in untreated ALL pts. Finally we compared the outcomes of untreated AML pts with ferritin ≥5,000 (n=25) to pts with definitive M-HLH (n=15) from our institution (Tamamyam et al., Cancer 2016) and noted a similar median OS (6 and 4 months, P=0.79). Conclusions: In this analysis, we have shown that adult pts with untreated and previously treated AML and ALL pts with ferritin ≥5,000 have an inferior survival. The optimal cut-off levels that discriminated survival were: 1807 (all AML), 903 (untreated AML), 3015 (all ALL). Untreated AML pts with ferritin ≥5,000 had a med OS of 6 months similar to pts with M-HLH. Significantly elevated ferritin in acute leukemia pts with febrile illness may be a marker to prompt a diagnostic work up for an underlying pathologic inflammation and potential benefit of augmented or targeted immune suppression. Disclosures Jabbour: ARIAD: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Novartis: Research Funding; BMS: Consultancy. Cortes:ARIAD: Consultancy, Research Funding; BMS: Consultancy, Research Funding; Novartis: Consultancy, Research Funding; Pfizer: Consultancy, Research Funding; Teva: Research Funding. Daver:Kiromic: Research Funding; BMS: Research Funding; Karyopharm: Honoraria, Research Funding; Ariad: Research Funding; Sunesis: Consultancy, Research Funding; Otsuka: Consultancy, Honoraria; Pfizer: Consultancy, Research Funding.

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