Serum ferritin values in primary care: are high values overlooked?

Abstract

Raised ferritin values are frequently found in samples submitted from primary care and most so in adult males. The authors also conclude that general practitioners require more guidance from haematologists in the management of patients with very high values.

Improved detection of hereditary haemochromatosis

“…In a high-risk North European population, SF values ≥200 μg/L (women) and ≥300 μg/L (men) were found in 10.6% and 17.2% of SF requests made from primary care on patients >30 years 24. We have now shown that 20% of these women and 35% of these men have Tsat >40% and >50%, respectively.…”

“…It is the most frequently measured haematinic in the UK, and since its general introduction in the 1980s, SF has replaced the measurements of serum iron and transferrin in primary care 23. Primary care physicians are familiar with the investigation and treatment of low SF values and iron deficiency but are much less comfortable with investigating patients with high SF values even when these values are grossly elevated 24. Transferrin is responsible for iron transport and raised Tsat reflects the potential for parenchymal iron loading and tissue damage 25.…”

Interpreting raised serum ferritin levels

“…6 It causes excessive absorption of dietary iron, but is often asymptomatic and unrecognised in primary care. 9 10 Associated morbidities (hepatic, endocrine, cardiac) are serious and preventable: timely diagnosis and treatment are important.…”

Serum Ferritin and Iron Studies - Laboratory Reporting and Clinical Application in Primary Care

“…However, a need for guidance in further investigation of elevated serum ferritin has recently been identified (Ogilvie et al, 2010). …”

“…It has however, also been shown that elevated serum ferritin is a common finding in the primary care population (Ogilvie et al, 2010) and that General Practioners (GPs) may require more guidance from Haematologists in the management of patients with raised serum ferritin levels. This will be explained and discussed with the aim of ultimately improving the diagnosis of serious underlying conditions including Hereditary Haemochromatosis (HHC).…”