Cerebrospinal fluid ferritin in newborn infants. Elevated levels in cerebral infection or bleeding.

One hundred and four infants with neurological symptoms or suspected infection during the neonatal period were consecutively investigated with respect to ferritin and albumin concentrations in the cerebrospinal fluid (CSF). In some cases serial determinations of CSF ferritin were performed during the period in the neonatal unit. CSF ferritin was significantly higher in infants that recovered very soon from a transient neonatal disorder (TND) than in apparently healthy adults. No difference in CSF ferritin was found between full-term infants with TND and pre-term infants with TND or asphyxiated infants. Three out of five infants with septicaemia or meninigitis showed a marked increase in CSF ferritin during the observation period, and the same finding was made in three infants with intracranial bleeding, in whom CSF ferritin values 100 times the upper reference limit for infants with TND were recorded. In two infants with neonatal convulsions secondary to asphyxia moderate CSF elevations were observed. No correlation was found between ferritin and albumin in CSF, suggesting that other mechanisms than passive penetration from blood into CSF must have been responsible for the raised levels of CSF ferritin. More likely the observed ferritin increments reflect ferritin release from macrophages undergoing phagocytosis either induced by cerebral bleeding or due to infectious agents.