Advertisement

Serum ferritin iron in iron overload and liver damage: Correlation to body iron stores and diagnostic relevance

      Abstract

      The iron content of serum ferritin has been determined in groups of patients with normal or increased iron stores by using a technique of ferritin immunoprecipitation followed by iron quantitation with atomic absorption spectroscopy. The results were correlated to individual liver iron concentrations, measured non-invasively by superconducting quantum interference device (SQUID) biomagnetometry. A close correlation between serum concentrations of ferritin protein and ferritin iron was found (r = 0.92) in all groups of patients. However, the correlation between ferritin iron concentration and individual liver iron concentration was poor in patients with hemochromatosis (r = 0.63) and patients with β-thalassemia major (r = 0.57). The degree of ferritin iron saturation was about 5% in iron-loaded patients, which contrasts with results in two recent studies but confirms older observations. In patients with liver cell damage, the ferritin iron saturation in serum was significantly higher than that found in groups with iron overload disease, probably indicating the release of intracellular iron-rich ferritin into the blood. The monitoring of patients undergoing bone marrow transplantation indicated that the release of iron-rich and iron-poor ferritin occurred during phases of hepatocellular damage and inflammation, respectively. We find the benefits of serum ferritin iron measurement to be marginal in patients with iron overload disease. (J Lab Clin Med 2000;135:413-8)

      Abbreviations:

      AAS (atomic absorption spectroscopy), GvH (graft-versus-host reaction), HFE (hemochromatosis gene on the short arm of chromosome 6), HH (hereditary hemochromatosis), LIC (liver iron concentration), SF-Fe (serum ferritin iron), SQUID (superconducting quantum interference device)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Translational Research
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Worwood M.
        Laboratory determination of iron status.
        in: Iron metabolism in health and disease. WB Saunders, London1994: 449-476
        • Powell LW.
        Primary iron overload.
        in: Iron metabolism in health and disease. WB Saunders, London1994: 227-270
        • Birgegard G
        • Hallgren R
        • Killander A
        • Stromberg A
        • Venge P
        • Wide L.
        Serum ferritin during infection.
        Scand J Hematol. 1978; 21: 333-340
        • Jacobs A.
        Serum ferritin and malignant tumors.
        Med Oncol Tumor Pharmacother. 1984; 1: 149-156
        • Herbert V
        • Shaw S
        • Jayatilleke E.
        Serum ferritin-iron (holoferritin): the first reliable (not confounded by inflammation) serum measurement of body iron stores.
        J Invest Med. 1995; 43: 198a
        • Herbert V
        • Shaw S
        • Jayatilleke E.
        High serum ferritin protein does not distinguish iron overload from inflammation, but a new assay, high serum-ferritin-iron, does.
        Am J Clin Nutr. 1995; 61: 911
        • Herbert V
        • Jayatilleke E
        • Shaw S
        • Rosman AS
        • Giardina P
        • Grady RW
        • et al.
        Serum ferritin iron, a new test, measures human body iron stores unconfounded by inflammation.
        Stem Cells. 1997; 15: 291-296
        • ten Kate J
        • Wolthuis A
        • Westerhuis B
        • van Deursen C.
        The iron content of serum ferritin: physiological importance and diagnostic value.
        Eur J Clin Chem Clin Biochem. 1997; 35: 53-56
        • Nielsen P
        • Fischer R
        • Engelhardt R
        • Tondüry P
        • Gabbe EE
        • Janka GE
        Liver iron stores in patients with secondary haemosiderosis under treatment with deferoxamine or deferiprone.
        Br J Haematol. 1995; 91: 827-833
        • Lindner MC
        • Schaffer KJ
        • Hazeh-Azam M
        • Zhou CYJ
        • Tran TN
        • Nagel GM.
        Serum ferritin: does it differ from tissue ferritin?.
        J Gastroenterol Hepatol. 1996; 11: 1033-1036
        • Cragg SJ
        • Wagstaff M
        • Worwood M.
        Detection of a glycosylated subunit in human serum ferritin.
        Biochem J. 1981; 199: 565-571
        • Worwood M
        • Dawkins S
        • Wagstaff M
        • Jacobs A.
        The purification and properties of ferritin from human serum.
        Biochem J. 1976; 157: 97-103
        • Arosio P
        • Yokota M
        • Drysdale JW.
        Characterisation of serum ferritin in iron overload: possible identity to natural apoferritin.
        Br J Haematol. 1977; 36: 199-207
        • Cragg SJ
        • Wagstaff M
        • Woorwood M.
        Sialic acid and microheterogeneity of human serum ferritin.
        Clin Sci. 1980; 58: 259-262
        • Pootrakul P
        • Josephson B
        • Huebers H
        • Finch C.
        Quantitation of ferritin in plasma, an explanation for non-transferrin iron.
        Blood. 1988; 71: 1120-1123
        • Halliday JW.
        Cellular iron processing and storage. The role of ferritin.
        in: Iron metabolism in health and disease. WB Saunders, London1994: 97-121
        • Düllmann J
        • Wulfhekel U
        • Hausmann K.
        Differences between Kupffer cells and endothelial cells of human liver in iron storage and release under normal conditions, after i.v. administration and in iron overload.
        in: Kupffer cells and other liver sinusoidal cells. Elsevier/North Holland Biomedical Press, Amsterdam1977: 233-241
        • Zuyderhoudt FMJ
        • Lindhorst C
        • Hengeveld P.
        On the iron content of human serum ferritin, especially in acute viral hepatitis and iron overload.
        Clin Chim Acta. 1978; 90: 93-99