Senjo Hajime, Higuchi Takakazu, Okada Sadamu, Takahashi Osamu
a Internal Medicine , St. Luke's International Hospital , Tokyo , Japan.
b Division of Hematology , St. Luke's International Hospital , Tokyo , Japan.
Hematology. 2018 Dec;23(10):817-822. doi: 10.1080/10245332.2018.1488569. Epub 2018 Jun 19.
To elucidate conditions which cause elevation of the serum ferritin, extent of the elevation in each condition, and clinical relevance of hyperferritinemia in general practice.
We retrospectively studied medical records of all patients who had at least one serum ferritin measurement above 500 μg L. Patients who had a marked elevation of the serum ferritin over 10,000 μg L were studied separately.
We studied 1394 patients to identify the etiologies of hyperferritinemia. Median serum ferritin level was 1024 μg L and 49.2% had ferritin levels of 501-1000 μg L. The most frequent cause of hyperferritinemia was non-human immunodeficiency virus infection followed by solid tumor, liver dysfunction, renal failure, and hematological malignancy. The distributions of the causes were different among groups stratified by the ferritin level. Forty-one percent had multiple causes and there was a tendency that the more underlying causes a patient had, the higher the ferritin level. Each condition led to a wide range of the ferritin level, and some patients could present with marked hyperferritinemia. Seventy percent of 111 patients with marked hyperferritinemia had multiple etiologies and a variety of diseases could lead to marked hyperferritinemia by themselves.
Patients with hyperferritinemia frequently had multiple conditions. The level of the serum ferritin was determined by the underlying conditions to a certain extent; however, the variation was significant. While patients with marked hyperferritinemia mostly had multiple underlying causes, various diseases could cause hyperferritinemia by themselves.
Hyperferritinemia is associated with both etiology and the number of underlying causes.
阐明导致血清铁蛋白升高的情况、每种情况下的升高程度以及一般实践中高铁蛋白血症的临床相关性。
我们回顾性研究了所有血清铁蛋白测量值至少有一次高于500μg/L的患者的病历。血清铁蛋白显著升高超过10000μg/L的患者单独进行研究。
我们研究了1394例患者以确定高铁蛋白血症的病因。血清铁蛋白水平中位数为1024μg/L，49.2%的患者铁蛋白水平在501 - 1000μg/L之间。高铁蛋白血症最常见的原因是非人类免疫缺陷病毒感染，其次是实体瘤、肝功能障碍、肾衰竭和血液系统恶性肿瘤。按铁蛋白水平分层的各组中病因分布不同。41%的患者有多种病因，并且有这样一种趋势，即患者的潜在病因越多，铁蛋白水平越高。每种情况都会导致铁蛋白水平有广泛的范围，并且一些患者可能表现出显著的高铁蛋白血症。111例显著高铁蛋白血症患者中有70%有多种病因，多种疾病本身可导致显著的高铁蛋白血症。
高铁蛋白血症患者常伴有多种情况。血清铁蛋白水平在一定程度上由潜在情况决定；然而，变化很大。虽然显著高铁蛋白血症患者大多有多种潜在病因，但多种疾病本身可导致高铁蛋白血症。
高铁蛋白血症与病因及潜在病因的数量均有关。
