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Correlation Between Serum Ferritin and Viral Hepatitis in Thalassemia Patients
Natthapat Rujeerapaiboon1, Adisak Tantiworawit1, Pokpong Piriyakhuntorn1
1Division of Hematology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Abstract:
Serum ferritin is an acute phase protein; importantly, its level is noticeably increased in response to iron overload and systemic inflammation. The iron overload status in thalassemia patients has been recognized as a potential way to measure liver iron concentration (LIC) levels using magnetic resonance imaging (MRI). The aim of this study was to investigate the effect of chronic viral hepatitis on the level of serum ferritin in patients with thalassemia. A cross-sectional study was conducted involving chronic viral hepatitis infection. Mean serum ferritin and LIC levels were recorded. The LIC values were used to divide the patients into two groups; a higher LIC group (>5 mg Fe/g) and a lower LIC group (<5 mg Fe/g). Mean serum ferritin levels were then compared between the two LIC groups. We identified 32 thalassemia patients comprising of 13 chronic viral hepatitis patients, seven patients with hepatitis B virus (HBV), and six patients with hepatitis C virus (HCV). With regard to the group with higher LIC values, the mean serum ferritin levels in the hepatitis group were significantly higher than for those in the non hepatitis group (1776 ± 488 vs. 967 ± 860 ng/mL, p = 0.03). Furthermore, the linear correlation between the mean serum ferritin levels and the viral load in the non transfusion-dependent thalassemia (NTDT) group were found to be significantly correlated (r = 0.7, p = 0.04). Chronic viral hepatitis was determined to be a possible casualty of disproportionately high ferritin levels in the NTDT group.
Insights
Chronic viral hepatitis significantly elevates serum ferritin levels in thalassemia patients, particularly those with higher liver iron concentration. This finding highlights viral hepatitis as a factor in increased ferritin in non-transfusion-dependent thalassemia.
Area of Science:
- Hematology
- Hepatology
- Medical Imaging
Background:
- Serum ferritin, an acute phase protein, increases with iron overload and inflammation.
- Thalassemia patients often experience iron overload, measurable by liver iron concentration (LIC) using MRI.
- Chronic viral hepatitis is a common comorbidity in thalassemia patients.
Purpose of the Study:
- To investigate the impact of chronic viral hepatitis on serum ferritin levels in thalassemia patients.
- To determine if viral hepatitis influences serum ferritin and liver iron concentration (LIC) in thalassemia.
Main Methods:
- A cross-sectional study involving 32 thalassemia patients with and without chronic viral hepatitis.
- Serum ferritin and LIC levels were measured; patients were grouped by LIC (>5 mg Fe/g vs. <5 mg Fe/g).
- Serum ferritin levels were compared between hepatitis-infected and non-infected groups, and correlated with viral load in non-transfusion-dependent thalassemia (NTDT).
Main Results:
- Thalassemia patients with chronic viral hepatitis showed significantly higher mean serum ferritin levels (1776 ± 488 ng/mL) compared to those without hepatitis (967 ± 860 ng/mL) in the higher LIC group (p=0.03).
- A significant positive linear correlation was observed between serum ferritin levels and viral load in the NTDT group (r=0.7, p=0.04).
Conclusions:
- Chronic viral hepatitis is a significant factor contributing to elevated serum ferritin levels in thalassemia patients, especially those with higher liver iron concentration.
- Elevated ferritin in non-transfusion-dependent thalassemia patients may be partly attributable to chronic viral hepatitis infection.
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