Hyperferritinemia in the Chinese and Asian Community: A Retrospective Review of the University of British Columbia Experience

Yenson, Paul R.; Yoshida, Eric M.; Li, Charles; Chung, Henry V; Tsang, Peter

doi:10.1155/2008/245096

Cited by 8 publications

(5 citation statements)

References 20 publications

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“…Abnormalities in markers of iron metabolism in non-hemochromatosis-associated liver disease are well-described ( 9 , 10 , 13 , 16 ). Metabolic disease and inflammation related hyperferritinemia is the most common manifestation, but increased stainable iron in liver tissue, increased transferrin, and inappropriate serum hepcidin levels have also been shown to occur in patients with non-hemochromatosis related liver disease ( 10 ).…”

Section: Discussionmentioning

confidence: 99%

“…Dysmetabolic iron overload is a related, though rarer condition with a mild increase in hepatic iron accumulation ( 12 ). Dysmetabolic hyperferritinemia has been reported to represent non-iron related causes of liver disease more commonly than iron overload in some populations ( 13 ). Hyperferritinemia has been reported to correlate with histologic severity of NAFLD and with presence of NASH independent of hepatic iron stores ( 10 , 14 ).…”

Section: Introductionmentioning

confidence: 99%

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Elevated serum ferritin in non-alcoholic fatty liver disease is not predictive of fibrosis

Trasolini

Cox

Galts

et al. 2022

CanLivJ

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Non-Alcoholic fatty liver disease (NAFLD) is common with widely ranging severity. Non-invasive risk scores for risk stratification are recommended but misclassify a significant proportion of patients. In situations where non-invasive risk scores do not provide guidance, referral is typically made to a Hepatologist for transient elastography or liver biopsy. Serum ferritin is elevated in many patients with NAFLD related to dysmetabolic and inflammatory hyperferritinemia. Ferritin is widely available and part of a standard workup for chronic liver disease. Methods: To explore the association of ferritin and risk of fibrosis in NAFLD, we reviewed patients diagnosed with NAFLD at the hepatology clinic of the Vancouver General Hospital between the years of 2015–2018. We collected data on 317 patients retrospectively assessing for a relationship between serum ferritin and elastography score. Results: 224 patients were included in the final analysis. Median ferritin was 145 µg/L (IQR 249). Median liver stiffness was 5.2 kPa with 14.3% of patients having liver stiffness ≥8.7 kPa and 17.4% ≥ 8.0 kPa. ROC curve analysis using a liver stiffness ≥8.0kPa as a cutoff for F2 fibrosis showed an AUROC of 0.54 for serum ferritin levels. At a cut-off of both 300 µg/L and 450 µg/L median liver stiffness did not differ significantly in those with ferritin above the cutoff (ferritin ≥300 µg/L p = 0.099, ferritin ≥450 µg/L p = 0.12). Ferritin was significantly higher in male patients (198 µg/L vs 91 µg/L p = 0.0001). There was a weak linear association between AST and ferritin levels. Conclusion: In this cohort of 224 patients with NAFLD, serum ferritin was not predictive of significant liver fibrosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Elevated serum ferritin in non-alcoholic fatty liver disease is not predictive of fibrosis

Trasolini

Cox

Galts

et al. 2022

CanLivJ

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“…The lack of information in Asian haemochromatosis is likely to be due to its low prevalence and mild phenotype. However, the prevalence of hyperferritinaemia is higher in Asians than Caucasians and true cases of iron overload in Asian patients may be even rarer as secondary causes, such as liver disease, metabolic syndrome and alcoholism account for most cases 4,7,18 . The prevalence of haemochromatosis in Asians may be underestimated due to concurrent secondary iron overload from thalassaemia, 3,19,20 or masked historically by low dietary iron.…”

Section: Discussionmentioning

confidence: 99%

“…Iron overload is described in Asian patients but is far less common. The vast majority of Caucasian iron overload is associated with homozygosity of the HFE gene mutation C282Y, but this is not seen in Asian patients 2–7 . Negative HFE gene testing in Asian patients may be misleading and cause the clinician to overlook an underlying primary iron overload disorder.…”

Section: Characteristic N (%)mentioning

confidence: 99%

Hyperferritinaemia and iron overload in Asian patients: lessons from an Australian tertiary centre experience

Con

Nicoll

2021

Internal Medicine Journal

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Iron overload is described in Asian patients but presents with a different phenotype and genotype compared to Caucasian patients. We retrospectively identified 64 Asian patients and compared them to 64 matched non‐Asian patients with at least one episode of serum ferritin >500 μg/L. Of the Asian patients, one (1.6%) had proven iron overload, while other common causes of hyperferritinaemia included recent blood transfusion (47%), acute infection (11%) and haematological malignancy (8%). A greater proportion of non‐Asian patients had hyperferritinaemia secondary to high alcohol intake. Iron overload is rare in Asians and unexplained hyperferritinaemia in Asian patients is more likely to be due to other factors.

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“…Yenson PR et al (6) did a retrospective case review of 80 patients of Asian ethnicity referred to three subspecialties in a tertiary care teaching hospital between January 1997 and March 2005 for assessment of hyperferritinemia. Only four patients (5%) had iron overload on liver biopsy or quantitative phlebotomy.…”

Section: Discussionmentioning

confidence: 99%

Causes of Hyperferritinemia in Qatar

Hammoudeh

Safarpour

2011

Qatar Medical Journal

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To assess the causes of high serum ferritin (over 1000 nanogram/ml) the records were reviewed of 145 samples of blood with ferritin levels over 1000 ng/ml taken in 2004 at Hamad Medical Corporation. The most common causes of hyperferritinemia in Qatar were found to be: end-stage renal failure, thalassemia major and sickle cell disease. Introduction: Ferritin is a globular protein complex consisting of 24 protein subunits and is the main intracellular iron storage protein in both prokaryotes and eukaryotes, keeping the iron in a soluble and non-toxic form. Ferritin is found principally in the intestinal mucosa, spleen, and liver, functioning as the primary form of iron storage in the body. (1) Ferritin that is not combined with iron is called apoferritin. Ferritin behaves as an acute phase reactant in various disease states such as rheumatoid arthritis, both adult and juvenile Still's disease, infections, and systemic lupus erythematosus. (2) Ferritin levels are high in patients with hemochromatosis, other liver diseases, alcoholism, renal diseases, malignancies, in patients who have had multiple transfusions , infection, and Still's disease. (3) We studied the files of all patients at our hospital who had high ferritin levels above 1000ng/ml during the year 2004.

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Hyperferritinemia in the Chinese and Asian Community: A Retrospective Review of the University of British Columbia Experience

Cited by 8 publications

References 20 publications

Elevated serum ferritin in non-alcoholic fatty liver disease is not predictive of fibrosis

Elevated serum ferritin in non-alcoholic fatty liver disease is not predictive of fibrosis

Hyperferritinaemia and iron overload in Asian patients: lessons from an Australian tertiary centre experience

Causes of Hyperferritinemia in Qatar

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