Serum ferritin values in primary care: are high values overlooked?

Area of Science:

• Clinical Biochemistry
• Primary Care Medicine
• Hematology

Background:

• Serum ferritin is a key indicator of iron status.
• Elevated ferritin can be associated with various conditions, including iron overload and inflammation.
• Understanding ferritin levels in primary care is crucial for appropriate patient management.

Purpose of the Study:

• To investigate serum ferritin values in iron-replete primary care patients.
• To determine the clinical actions taken for patients with very high serum ferritin levels (>1000 μg/l).

Main Methods:

• Retrospective analysis of serum ferritin values from 4170 consecutive primary care patients.
• All ferritin measurements were requested by general practitioners.
• Focus on patients identified with elevated ferritin levels.

Main Results:

• Serum ferritin levels in males stabilized by age 30, with 17% exceeding 300 μg/l.
• Female ferritin values increased with age; by 70 years, 8% had levels >300 μg/l.
• Fifty-nine patients had ferritin >1000 μg/l, with 32 cases lacking explanation or investigation.

Conclusions:

• Raised serum ferritin is frequently observed in primary care samples, especially in adult males.
• A significant proportion of very high ferritin cases (>1000 μg/l) were unexplained.
• General practitioners require enhanced guidance from hematologists for managing elevated ferritin.