Korean J Blood Transfus.  2018 Dec;29(3):273-281. 10.17945/kjbt.2018.29.3.273.

Causes of Hyperferritinemia and Red Blood Cell Transfusion

• Kim MS
• Kim SH

• KMID: 2435621
• DOI: http://doi.org/10.17945/kjbt.2018.29.3.273

Abstract

BACKGROUND
Ferritin is used to detect iron overload in patients with chronic red blood cell transfusions. Although ferritin reflects the amount of iron storage in the body, it may increase nonspecifically in inflammation and infection. This study analyzed the cause of increased ferritin and the association with a red blood cell (RBC) transfusion.
METHODS
The medical records of patients who visited the authors' hospital from January to December 2017 and underwent a ferritin test were reviewed retrospectively. Hyperferritinemia was defined as a ferritin level more than 1,000 ng/mL. The causes of hyperferritinemia were investigated by examining the laboratory findings and medical records.
RESULTS
The results revealed 417 cases of hyperferritinemia in 238 patients during the period. The most common diseases were hematologic malignancies from 125 cases (30.0%) in 31 patients and infectious diseases were the second most common. Iron overload was suspected in 119 cases in 33 patients, and 12 patients (76 cases) were transfused with more than 8 units of RBC for 1 year before the test.
CONCLUSION
In hyperferritinemia, the rate of iron overload is high considering the underlying diseases and chronic RBC transfusion. To determine iron storage status accurately, it will be helpful to measure the C-reactive protein (CRP) and iron saturation in the ferritin test. Careful attention should be paid to habitual iron formulations and frequent transfusions due to the possibility of iron overload.

Keyword

Hyperferritinemia; Iron overload; Red blood cell; Transfusion

MeSH Terms

C-Reactive Protein
Communicable Diseases
Erythrocyte Transfusion*
Erythrocytes*
Ferritins
Hematologic Neoplasms
Humans
Inflammation
Iron
Iron Overload
Medical Records
Retrospective Studies
C-Reactive Protein
Ferritins
Iron