Severe hyperferremia and hyperferritinemia in a dog with precursor-directed immune-mediated anemia

A 4-year-old dog was evaluated at the Colorado State University Veterinary Teaching Hospital for lethargy and hyporexia of 24 hours duration. On presentation, she had a marked normocytic, normochromic, nonregenerative anemia (HCT 14%; RI 40-55). Her serum iron concentration (1651 μg/dL; RI 73-245) and serum ferritin concentration (1337 ng/mL; RI 89-489) were markedly elevated. Bone marrow aspirate and core biopsy were consistent with a diagnosis of precursor-directed immune-mediate anemia. To the authors' knowledge, these are the highest reported serum iron and ferritin concentrations in a patient with precursor-directed immune-mediate anemia. The iron concentration improved significantly after treatment, supporting the theory that the hyperferremia was due to hemolysis and ineffective erythropoiesis.