HYPERFERRITINEMIA (in adults) overview Ferritin isa cytosolic protein that s mast portant fits ability t store up 9 4500 ran atoms os ‘molecule Levale of fern reflce ngracsiuisr om layla in heathy inswiduals. with oduetin bem Soreguned 0 ren eval nreoe rum fertinsthus common macsurgd ban an nso levated serum ferritin (a. ferritin 2300 yg/L) hypérferritinema, is 2 common finding during routine nloodivarl ut may hove greater signficanas tron ran veriagd Inasee,n round 90% of hyparferstinemis Eases, ron overloads not present Extracellular farnitn ie also moved in many functions urweites to niracalular npn storage For svamale fein is an acute phase reactor ana serum eoneaneation ¢ fluctuate by 25% or more during inflommatory states, Unexpectedly high feria level coulateretore signal Conver fof Asian ard Affican American descent are often found to have feria love's DIFFERENTIAL DIAGNOSIS rly 10%, oF clinical cases of nipefertinamia in outine madicol practice are asiclated vith ani cyerioea, the dfterntiation of njourierntingmia perontal ance the monjement wal ifr aecorcing ‘metabolic syndrome. chronic alcanol consumption, cellular damage, and malignancy ‘Table 1). There 3 olse mora rare unclryine Gavenar Sirsase (GD) hich may be overlooved dye tna ver 1 ina study of over a thousand patiants witn nyperternitinmia (macin serum fcritin inv 1024 yar. the ‘mast commonly renoriea cause was non-human imunadeflelency vfus infection foioWed by Soil furmor Liver aisaase, such as hapattis 2, steatohepatitis, sa commonty associated with noth hyperferitinemia and ‘able 1. Potential underlying causes of hyperferritinemia. An indicative workflow fo eluciting the underlying cause of hyperteritineria i presented in Figur ‘may help identify if hyperferritinemia isthe result of one of thase. These conditions clude alcohol sm. Fepatle steatosis steatonepstive ane any form of acvke pnase reactions.Tbdgaatas sue UT} Genetic testing can determine whether hyperferritinemia arses from a gene mutation hiss particularly feiovantf the patant hata farnly ratory f elevated forrkin evel APE tasting for type Hereditary Hlomochromatosis is mandatory i nynarfrntinamis ie sovpelat to slevated tarafern saturstion CTSAT). IF this tests negative and/or there is aeitel suspicion of rorr gontic disorders, a second lovel genetic 9st nay be performed’ (for example art generation sequencing (NGS) of tSrget Genes) [An extreme eleva of feritn, 2,210,000 ng/t. is space for Nemonhagocyticlymahhstacytoss in the Dediatre population whiain aduts can be dbearved also In othar conditions la aduivonsat Sl = cieaase Penal falure. hepavoeallornjiy, infections and hematological malignancy” Figure 1 Possible workfow for determining atiology of hyperteritinemia! KEY POINTS ; Dillon agnosis includes 9 wider varity of potent cous incucing malignancy, alcohol often occurs with splenomegaly