The role of serum ferritin in the management of idiopathic haemochromatosis.

The value of the serum ferritin assay in the management of idiopathic haemochromatosis has been examined in groups of patients at diagnosis, during venesection therapy, and following completion of therapy. At diagnosis, serum ferritin levels were elevated in all 16 patients studied, including 10 with precirrhotic disease. Venesection resulted in a gradual fall in serum ferritin which commenced shortly after the start of treatment in 5/8 patients. In 3/8 the fall was preceded by a transient rise in ferritin levels. In three patients serum ferritin fell to normal before liver iron stores had been restored to normal. After therapy serum ferritin proved unreliable in detecting early re-accumulation of hepatic iron stores. Serum ferritin does provide valuable information in patients with idiopathic haemochromatosis, particularly at diagnosis and during therapy. A normal value does not exclude iron storage disease.