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      Marked hyperferritinemia does not predict for HLH in the adult population

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          Key Points

          Highly elevated ferritin is not specific for hemophagocytic lymphohistiocytosis in adults. Marked hyperferritinemia in adults most often occurs in the setting of renal failure, hepatocellular injury, infection, or malignancy.

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          Serum ferritin: Past, present and future.

          Yan-Wei Wang, Katy Coffman, Suzy Torti … (2010)
          Serum ferritin was discovered in the 1930s, and was developed as a clinical test in the 1970s. Many diseases are associated with iron overload or iron deficiency. Serum ferritin is widely used in diagnosing and monitoring these diseases. In this chapter, we discuss the role of serum ferritin in physiological and pathological processes and its use as a clinical tool. Although many aspects of the fundamental biology of serum ferritin remain surprisingly unclear, a growing number of roles have been attributed to extracellular ferritin, including newly described roles in iron delivery, angiogenesis, inflammation, immunity, signaling and cancer. Serum ferritin remains a clinically useful tool. Further studies on the biology of this protein may provide new biological insights. Copyright 2010 Elsevier B.V. All rights reserved.
          Article 0 comments Cited 206 times – based on 0 reviews     Review now
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            Ferritin: structure, gene regulation, and cellular function in animals, plants, and microorganisms.

            E H Theil (1986)
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              Serum ferritin is derived primarily from macrophages through a nonclassical secretory pathway.

              Matthias W Hentze, William Weiss, Daniel Morgenstern … (2010)
              The serum ferritin concentration is a clinical parameter measured widely for the differential diagnosis of anemia. Its levels increase with elevations of tissue iron stores and with inflammation, but studies on cellular sources of serum ferritin as well as its subunit composition, degree of iron loading and glycosylation have given rise to conflicting results. To gain further understanding of serum ferritin, we have used traditional and modern methodologies to characterize mouse serum ferritin. We find that both splenic macrophages and proximal tubule cells of the kidney are possible cellular sources for serum ferritin and that serum ferritin is secreted by cells rather than being the product of a cytosolic leak from damaged cells. Mouse serum ferritin is composed mostly of L-subunits, whereas it contains few H-subunits and iron content is low. L-subunits of serum ferritin are frequently truncated at the C-terminus, giving rise to a characteristic 17-kD band that has been previously observed in lysosomal ferritin. Taken together with the fact that mouse serum ferritin is not detectably glycosylated, we propose that mouse serum ferritin is secreted through the nonclassical lysosomal secretory pathway.
              Article 0 comments Cited 150 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Nancy Berliner: (View ORCID Profile)
                Journal
                Title: Blood
                Publisher: American Society of Hematology
                ISSN (Print): 0006-4971
                ISSN (Electronic): 1528-0020
                Publication date Created: March 05 2015
                Publication date (Print): March 05 2015
                Volume: 125
                Issue: 10
                Pages: 1548-1552
                Affiliations
                [1 ]Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;
                [2 ]Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA; and
                [3 ]Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;
                [4 ]Division of Hematology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA; and
                [5 ]Division of Rheumatology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
                Article
                DOI: 10.1182/blood-2014-10-602607
                PubMed ID: 25573993
                SO-VID: f1d5056c-18bb-4ae2-82cb-66629bf42668
                Copyright © © 2015
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