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Low isolated ferritin levels without anemia: is gastrointestinal tract endoscopy sufficient to explain the cause?
Ayşenur Bahadir1, Elif Sag2, Murat Çakır2
1Division of Pediatric Hematology-Oncology, Faculty of Medicine, Karadeniz Technical University, Trabzon, Turkey. aysenurkbr@yahoo.com.
Insights
Low ferritin levels without anemia in children may indicate early signs of gastrointestinal diseases like Helicobacter pylori gastritis and celiac disease. This finding highlights the diagnostic importance of monitoring ferritin levels even in non-anemic pediatric patients.
Area of Science:
- Pediatric Gastroenterology
- Internal Medicine
- Hematology
Background:
- Iron deficiency is often associated with anemia, but low ferritin levels can occur without it.
- The diagnostic significance of low ferritin levels without anemia in pediatric gastrointestinal diseases requires further investigation.
Purpose of the Study:
- To assess the diagnostic value of low ferritin levels in pediatric gastrointestinal diseases.
- To evaluate endoscopic findings in children with low ferritin levels but no anemia.
Main Methods:
- Retrospective analysis of 2391 pediatric patients (aged 0-18 years) who underwent gastrointestinal endoscopy.
- Patients were categorized based on hemoglobin and ferritin levels.
- Endoscopic and histopathological findings were recorded.
Main Results:
- 23% of patients had low ferritin levels without anemia.
- Abdominal pain, dyspepsia, and growth retardation were common symptoms.
- Helicobacter pylori gastritis (24%) and celiac disease (6%) were significantly more prevalent in the low ferritin without anemia group compared to non-anemic controls.
Conclusions:
- Low ferritin levels without anemia are associated with a higher incidence of Helicobacter pylori gastritis and celiac disease in children.
- Low ferritin levels in pediatric patients may serve as an early, silent indicator of celiac disease.
Aim:
The present study assesses the diagnostic significance of low ferritin levels in gastrointestinal diseases by evaluating the endoscopic findings of patients with low ferritin levels without anemia.
Method:
The study included patients aged 0-18 years who underwent an upper and lower gastrointestinal system endoscopy in the Pediatric Gastroenterology Department of our hospital. The patients were divided into three groups based on hemoglobin, and ferritin levels at the time of initial presentation and endoscopic and histopathological findings were recorded retrospectively.
Results:
In the present study, 2391 pediatric patients were reviewed, among which 29% (n = 699) had anemia, 23% (n = 549) had low ferritin levels without anemia, and 48% (n = 1143) did not have anemia. The most common symptoms were abdominal pain, dyspepsia, and growth retardation. When the endoscopy findings were compared with those of patients with non-anemic group, Helicobacter pylori gastritis (24%/17.6%) and celiac disease (6%/2.2%) were more common in low ferritin levels without anemia, which indicated a statistically significant difference (p = 0.000/p = 0.04).
Conclusions:
Helicobacter pylori gastritis and celiac disease were more commonly observed in association with low ferritin levels. Low ferritin levels without anemia can be an early and silent sign of celiac disease.
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