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Ferritinophagy: Assessing the Selective Degradation of Iron by Autophagy in Human Fibroblasts
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Elevated serum ferritin - what should GPs know?

Katie Goot1, Simon Hazeldine, Peter Bentley

  • 1UQ Rural Clinical School, Rockhampton, Queensland, Australia. k.goot@uq.edu.au

Australian Family Physician
|December 5, 2012
PubMed
Summary

Elevated serum ferritin often results from non-iron overload causes. Investigating these conditions, rather than iron overload, is key for appropriate patient management.

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Area of Science:

  • Clinical Medicine
  • Biochemistry
  • Genetics

Background:

  • Elevated serum ferritin is a frequent finding in primary care.
  • Most cases (90%) stem from non-iron overload conditions.
  • Venesection is not the primary treatment for these non-iron overload states.

Purpose of the Study:

  • To detail the Australian Red Cross Blood Service Therapeutic Venesection program.
  • To clarify interpretation of HFE gene testing and iron studies.
  • To outline the diagnostic approach for elevated serum ferritin.

Main Methods:

  • Review of existing literature and clinical guidelines.
  • Analysis of the role of the Australian Red Cross Blood Service.
  • Guidance on interpreting HFE gene tests and iron studies.

Main Results:

  • Hereditary hemochromatosis must be excluded first.
  • Common causes include alcohol, metabolic syndrome, obesity, diabetes, liver disease, malignancy, infection, and inflammation.
  • Therapeutic venesection is primarily for iron overload conditions.

Conclusions:

  • Further investigation focuses on non-iron overload etiologies.
  • Referral is advised for serum ferritin >1000 µg/L or unclear causes.
  • Specialist consultation (gastroenterology, hematology) may be necessary.