Extreme hyperferritinemia in restrictive type anorexia nervosa

Area of Science:

• Endocrinology
• Nutritional Science
• Hematology

Background:

• Iron metabolism is frequently altered in patients with anorexia nervosa (AN).
• The association between hyperferritinemia and AN is not fully understood.
• Elevated ferritin levels in AN may be linked to nutritional status and body weight fluctuations.

Purpose of the Study:

• To report a case of extreme hyperferritinemia in a patient with AN.
• To discuss potential mechanisms and existing knowledge regarding hyperferritinemia in AN.
• To investigate the relationship between ferritin levels, weight changes, and physical activity in AN.

Main Methods:

• Case report of a 20-year-old female patient with AN presenting with extreme hyperferritinemia.
• Clinical assessment for systemic, hematological, or malignant causes of hyperferritinemia.
• Monitoring of ferritin levels in relation to body weight and clinical symptoms.

Main Results:

• The patient presented with bradycardia, weariness, and malaise, alongside incidentally very high ferritin levels.
• Symptoms resolved spontaneously post-admission, with no identified underlying disease.
• While ferritin levels decreased with initial weight gain post-discharge, a clear dynamic association with weight or activity was not established.
• Approximately 25% of AN patients exhibit increased ferritin concentrations.

Conclusions:

• Extreme hyperferritinemia can occur in AN patients without other identifiable causes.
• Further research is needed to elucidate the complex relationship between iron metabolism, ferritin levels, and nutritional status in AN.
• This case represents the highest reported ferritin concentration in an AN patient without comorbidities.