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Cutoff Values for Serum Ferritin in Predicting Cirrhosis Severity due to Cholestatic Jaundice in Vietnamese Children
Ha-Van Thieu1,2, Thach Binh Minh1, Tran-Thi Khanh Tuong3
1Department of Pediatrics, Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam.
Insights
High serum ferritin levels can predict liver cirrhosis severity in children. A cutoff of 195 μg/l for serum ferritin effectively identifies decompensated cirrhosis in pediatric patients with cholestatic jaundice.
Area of Science:
- Pediatric Hepatology
- Biomarker Discovery
- Clinical Chemistry
Background:
- Elevated serum ferritin levels correlate with liver cirrhosis severity and poorer outcomes in liver disease.
- Cholestatic jaundice in children can lead to significant liver damage and cirrhosis.
Purpose of the Study:
- To establish serum ferritin cutoff values for predicting cirrhosis severity in pediatric patients with cholestatic jaundice.
- To evaluate the utility of serum ferritin as a biomarker for decompensated cirrhosis in children.
Main Methods:
- Retrospective analysis of 95 pediatric patients (1 month to 16 years) diagnosed with cirrhosis.
- Utilized Receiver Operating Characteristic (ROC) curve analysis to determine optimal ferritin cutoff values.
- Correlated serum ferritin levels with Child-Pugh scores to assess disease severity.
Main Results:
- A serum ferritin cutoff of 195 μg/l was identified for predicting decompensated cirrhosis (Sensitivity: 65.22%, Specificity: 95.83%, AUC: 0.82).
- Higher ferritin levels were observed in Child-Pugh C compared to Child-Pugh A and B groups (p < 0.001).
- The 195 μg/l ferritin cutoff also distinguished between Child-Pugh classifications (Sensitivity: 71.2%, Specificity: 87.9%, AUC: 0.80).
Conclusions:
- Serum ferritin levels are significantly associated with decompensated cirrhosis and overall disease severity in children.
- Routine serum ferritin testing can aid in predicting cirrhosis severity in pediatric cholestatic jaundice.
- The established cutoff value provides a valuable tool for risk stratification and management decisions.
Background:
High serum ferritin levels are associated with liver cirrhosis severity and worse outcomes for hepatopathies. This study determined the serum ferritin cutoff values for predicting cirrhosis severity in children with cholestatic jaundice.
Methods:
A retrospective study was performed, including all cases diagnosed with cirrhosis in children aged 1 month to 16 years at Children's Hospital 2-Vietnam between 2016 and 2021. Receiver operating characteristic (ROC) curve analysis was used to estimate ferritin cutoff values for predicting disease severity.
Results:
The study included 95 patients with cirrhosis due to cholestatic jaundice. Decompensated cirrhosis accounted for the majority (74.7%) of cases. Increased serum ferritin concentrations predicted cirrhosis severity in children, and the optimal ferritin cutoff value for predicting decompensated cirrhosis was determined to be 195 μg/l, resulting in a sensitivity of 65.22%, a specificity of 95.83%, and an area under the ROC curve (AUC) or 0.82. The Child-Pugh C group had higher ferritin levels than the Child-Pugh A and B group (p < 0.001), and the ferritin cutoff value for distinguishing between Child-Pugh classifications was 195 μg/l, resulting in a sensitivity of 71.2%, a specificity of 87.9%, and an AUC of 0.80.
Conclusions:
Serum ferritin levels are significantly associated with decompensated cirrhosis and disease severity (as assessed by Child-Pugh score). Routine serum ferritin testing may contribute to predicting cirrhosis severity in children.
