Ferritin and iron in pediatric infections in the emergency department: A pilot study

Abstract

We aimed to study ferritin as an acute phase marker in pediatric infections, and investigate its' clinical significance in the emergency department management of the febrile child. Multiple inflammatory markers, including C-reactive protein, procalcitonin, and serum ferritin, and other iron studies were measured in 37 children, from 3 months through 8 years of age, presenting to the emergency department with temperature of 39 degrees Celsius, and 38 patients in the same age group with non-febrile illness. Mean serum ferritin was significantly higher in the febrile group 71.4 ng/mL compared to the non-febrile group 45.1 ng/mL (p < 0.003). Ferritin/iron ratio was 5.28 in the febrile group and 1.72 in the non-febrile group (p < 0.046). Mean serum iron level was significantly lower in the in Febrile compared to non-febrile children. Mean serum iron was also significantly lower in the subgroup of children with bacterial infection: 17.5 µg/dL compared to the group with viral infection 27.1 µg/dL (p < 0.001). The results of this pilot study in the Emergency Department setting confirm previous work from hospitalized patients indicating that ferritin is increased and serum iron is decreased in pediatric infections. Further studies are needed to confirm our findings and to further explore the role of serum iron as a marker of bacterial infection.