Serum Ferritin in Cirrhosis: The Preliminary Report
Article Sidebar
Main Article Content
Abstract
Introduction: Primary hemochromatosis is opposed to the hepatitis B virus as the cause of chronic liver diseasesin Thailand. When the cirrhotic patients are shown to have HBsAg, the iron study will be automatically neglected.Patients and Methods: This cross-sectional study was performed to explore the serum ferritin, hepatitis B and Cviruses in the cirrhotic patients who were proved to be free from severe thalassemian or chronic kidney disease.Results: Thirty cirrhotic patients, 15 males, mean age 57.2+9.8 years, were enrolled. The serum ferritin wasfound to range from 15.1 to 9,455, mean 1,685.5+2,335.7 ng/ml, the transferrin saturation ranged from 23.6 to54.8, mean 38.6+8.4% while HBsAg and HCV were found in 6 (20.0%) and 2 patients (6.7%), respectively. Thehyperferritinemia (serum ferritin >1,000 ng/ml) was found in 14 patients (46.7%). Four from 6 patients withHBsAg had the hyperferritinemia but the prevalence was not different from the patients without HBsAg (p=0.272).Conclusion: The hyperferritinemia is found in nearly half cases of cirrhotic patients regardless of hepatitis Bvirus and its prevalence is 2-fold and 7-fold of hepatitis B and C viruses respectively.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Waalen J, Felitti VJ, Gelbart T, Beutler E. Screening for hemochromatosis by measuring ferritin levels: a more effective approach. Blood 2008; 111: 3373-6.
Viprakasit V, Vathesathokit P, Chinchang W, Tachavanich K, Pung-Amritt P, et al. Prevalence of HFE mutations among the Thai population and correlation with iron loading in haemoglobin E disorder. Eur J Haematol 2004; 73: 43-9.
Tripatara A, Srichana N, Lamool P, Amnuaykan S, Hongart P, Jetsrisuparb A. Relationship between plasma ferritin level and siderocyte number in splenectomized β-thalassemia/HbE patients. Anemia 2012; 2012: 890471. doi: 10.1155 / 2012 / 890471. Epub 2012 Oct 24.
Rattanamongkolgul S, Wongjitrat C, Puapankitcharoen P. Prevalence of cirrhosis registered in Nakhon Nayok, Thailand. J Med Assoc Thai 2010; 93: S87-S91.
Porapakkham Y, Rao C, Pattaraarchachai J, Polprasert W, Vos T, Adair T, et al. Estimated causes of death in Thailand, 2005: implications for health policy. Population Health Metrics 2010, 8: 14. doi:10.1186/1478-7954-8-14.
Tangkijvanich P, Theamboonlers A, Hirsch P, Thongngam D, Kullavanijaya P, Poovorawan Y. Hepatitis viruses and chronic liver disease. Southeast Asian J Trop Med Public Health 1999; 30: 489-95.
Sebastiani G, Vario A, Ferrari A, Pistis R, Noventa F, Alberti A. Hepatic iron, liver steatosis and viral genotypes in patients with chronic hepatitis C. J Viral Hepat 2006; 13: 199-205.
Pramoolsinsap C, Promvanit N, Komindr S, Lerdverasirikul P, Srianujata S. Serum trace metals in chronic viral hepatitis and hepatocellular carcinoma in Thailand. J Gastroenterol 1994; 29: 610-5.
Intragumtornchai T, Rojnukkarin P, Swasdikul D, Israsena S. The role of serum ferritin in the diagnosis of iron deficiency anaemia in patients with liver cirrhosis. J Intern Med 1998; 243: 233-41.
Lee MH, Means RT Jr. Extremely elevated serum ferritin levels in a university hospital: associated diseases and clinical significance. Am J Med 1995; 98: 566-71.
Merican I, Guan R, Amarapuka D, Alexander MJ, Chutaputti A, Chien RN, et al. Chronic hepatitis B virus infection in Asian countries. J Gastroenterol Hepatol 2000; 15: 1356-61.
Fletcher LM, Powell LW. Hemochromatosis and alcoholic liver disease. Alcohol 2003; 30:131-6.
Sebastiani G, Tempesta D, Alberti A. Hepatic iron overload is common in chronic hepatitis B and is more severe in patients coinfected with hepatitis D virus. J Viral Hepat 2012; 19(2): e170-6. doi: 10.1111/j.1365-2893.2011. 01508.x. Epub 2011 Sep 14.
Diwakaran HH, Befeler AS, Britton RS, Brunt EM, Bacon BR. Accelerated hepatic fibrosis in patients with combined hereditary hemochromatosis and chronic hepatitis C infection. J Hepatol 2002; 36: 687-91.
Berkham L. Interpretation of an elevated serum ferritin. NZFP 2002; 29: 44-8.
Ohkoshi S, Yoshimura A, Yamamoto S, Yano M, Kurita S, Yamazaki K, et al. Successful treatment with lamivudine may correlate with reduction of serum ferritin levels in the patients with chronic hepatitis and liver cirrhosis type B. Hepatol Int 2008; 2: 382-7.
Bell H, Skinningsrud A, Raknerud N, Try K. Serum ferritin and transferrin saturation in patients with chronic alcoholic and non-alcoholic liver diseases. J Intern Med 1994; 236: 315-22.
Hann HWL, Kim CY, London WT, Blumberg BS. Increased serum ferritin in chronic liver disease: A risk factor for primary hepatocellular carcinoma. Intern J Cancer 1989; 43: 376-9.