The causes of rising and lowering ferritin in the blood

The results of the ferritin test may be false-positive or false-negative in inflammation (ferritin refers to acute phase proteins), tumors, liver pathology, when ferritin content may be increased. In a number of cases, patients who are on hemodialysis, have a paradoxically increased level of ferritin in the accumulation of iron in the cells of the reticuloendothelial system. Thus in the bone marrow there can be a simultaneous deficiency of iron. Therefore, in the evaluation of iron metabolism, complex studies should be carried out.

Negative balance of iron for a long time leads to the development of iron deficiency. There are three stages of failure, leading to the most severe form - iron deficiency anemia. Symptoms and symptoms of the disease in the patient also progress, depending on the presence and extent of anemia.

• Reduced iron stocks (stage 1): iron stores in the bone marrow and liver decrease. The patients have no symptoms, the hemoglobin concentration is within the normal range. The concentration of ferritin in the serum and the amount of iron in the red bone marrow are reduced. The main signs of iron depletion are an increase in its absorption, indicating an increased vulnerability or the possibility of developing iron deficiency.
• Iron deficiency erythropoiesis (stage 2): the activity of erythropoiesis is reduced due to the lack of iron necessary for inclusion in the hemoglobin hemoglobin. The concentration of hemoglobin in the blood begins to decrease, the content of free protoporphyrin in erythrocytes increases. This stage is also characterized by the absence or decrease in the amount of iron stores, low serum iron concentration, increased OLCF, and low saturation of transferrin. The parameters of hematocrit practically do not differ from normal ones.
• Iron deficiency anemia (stage 3) is the unfolded stage of the disease. The serum ferritin content and saturation of transferrin are very low. Other laboratory features of this stage include: a decrease in the amount of iron stores, a low serum iron concentration, an increase in OLCs, and a low concentration of hemoglobin.

An increase in serum ferritin levels can be detected in the following diseases: with excess iron content [eg, hemochromatosis (ferritin concentration above 500 μg / l), certain liver diseases), inflammatory processes (pulmonary infections, osteomyelitis, arthritis, systemic lupus erythematosus , burns), some acute and chronic diseases with liver cells (alcoholic liver damage, hepatitis), breast cancer, acute myeloblastic and lymphoblastic leukemia, and lymphogranulomatosis. When evaluating the results of an elevated ferritin concentration, it should be borne in mind that it refers to the proteins of the acute phase, therefore, its increase can reflect the body's response to the inflammatory process. In such cases, if there is a suspected presence of hemochromatosis, it is necessary to simultaneously determine the concentration of serum iron and OZHS. If the ratio of serum iron to OGSS exceeds 50-55%, then, most likely, the patient has hemochromatosis, and not hemosiderosis.

The determination of ferritin is most important in the diagnosis of iron metabolism disorders. Reduction of ferritin is detected in iron deficiency and hemolytic anemia with intravascular hemolysis. In patients with chronic kidney disease, inadequate accumulation of iron in the body can be ascertained when the serum content of ferritin is below 100 μg / l.

The use of the definition of ferritin in the diagnosis and monitoring of cancer is based on the fact that in some organs and tissues in the presence of neoplasms (acute myeloblastic and lymphoblastic leukemia, lymphogranulomatosis, liver tumors) there is a violation of the deposition of iron, and this leads to an increase in serum ferritin, and also enhanced its release from the cells upon their death.