Relationship of Body Iron Stores to Levels of Serum Ferritin, Serum Iron, Unsaturated Iron Binding Capacity and Transferrin Saturation in Patients with Iron Storage DiseaseBeutler E.a · Felitti V.b · Ho N.J.a · Gelbart T.a
aThe Scripps Research Institute, La Jolla, Calif., and bKaiser Permanente, Department of Preventive Medicine, SanDiego, Calif., USA
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None of the methods for assessing total body iron burden in patients with hemochromatosis is satisfactory. Although it is commonly believed that a relationship exists between serum ferritin levels and total iron burden, the extent of this relationship has not previously been documented. In the present investigation we measured the total body iron burden of 88 patients with putative hemochromatosis, 54 of whom were homozygotes for the 845G→A (C282Y) mutation. The total body iron stores were estimated from the volume of red cells removed during therapeutic phlebotomy corrected for an estimated 2 mg/day dietary iron absorbed during the phlebotomy period; the amount of storage iron was compared to the serum ferritin, serum iron, unsaturated iron binding capacity, and transferrin saturation before the beginning of phlebotomy. The serum ferritin proved to be the best predictor of body iron stores. The correlation between all of the analytes and the body iron burden was greater in patients homozygous for the C282Y mutation than in those who were not, including the compound heterozygotes for C282Y and H63D. The body iron burden tended to be greater in patients homozygous for the C282Y mutation than the other patients at any other given ferritin level. We conclude that the serum ferritin level does provide some information regarding total iron burden but even in the case of C282Y homozygotes, the correlation is not very strong.
© 2002 S. Karger AG, Basel
- Olynyk JK, Luxon BA, Britton RS, Bacon BR: Hepatic iron concentration in hereditary hemochromatosis does not saturate or accurately predict phlebotomy requirements. Am J Gastroenterol 1998;93:346–350.
- Bondestam S, Lamminen A, Anttila V-J, Ruutu T, Ruutu P: Magnetic resonance imaging of transfusional hepatic iron overload. Br J Radiol 1994;67:339–341.
- Gandon Y, Guyader D, Heautot JF, Reda MI, Yaouanq J, Buhe T, Brissot P, Carsin M, Deugnier Y: Hemochromatosis: Diagnosis and quantification of liver iron with gradient-echo MR imaging. Radiology 1994;193:533–538.
- Ernst O, Sergent G, Bonvarlet P, Canva-Delcambre V, Paris JC, L’Hermine C: Hepatic iron overload: Diagnosis and quantification with MR imaging. Am J Roentgenol 1997;168:1205–1208.
- Bonkovsky HL, Rubin RB, Cable EE, Davidoff A, Rijcken THP, Stark DD: Hepatic iron concentration: Noninvasive estimation by means of MR imaging techniques. Radiology 1999;212:227–234.
- Brittenham GM, Sheth S, Allen CJ, Farrell DE: Noninvasive methods for quantitative assessment of transfusional iron overload in sickle cell disease. Semin Hematol 2001;38:37–56.
- Nielsen P, Gunther U, Durken M, Fischer R, Dullmann J: Serum ferritin iron in iron overload and liver damage: Correlation to body iron stores and diagnostic relevance. J Lab Clin Med 2000;135:413–418.
- Cook JD, Lipschitz DA, Miles LEM, Finch CA: Serum ferritin as a measure of iron stores in normal subjects. Am J Clin Nutr 1974;27:681–687.
- Walters GO, Miller FM, Worwood M: Serum ferritin concentration and iron stores in normal subjects. J Clin Pathol 1973;26:770–772.
- Mazza P, Giua R, De Marco S, Bonetti MG, Amurri B, Masi C, Lazzari G, Rizzo C, Cervellera M, Peluso A: Iron overload in thalassemia: Comparative analysis of magnetic resonance imaging, serum ferritin and iron content of the liver. Haematologica 1995;80:398–404.
- Beutler E, Felitti V, Gelbart T, Ho N: The effect of HFE genotypes in patients attending a health appraisal clinic. Ann Intern Med 2000;133:329–337.
- Adams P, Brissot P, Powell L: EASL International Consensus Conference on Haemochromatosis. II. Expert document. J Hepatol 2000;33:487–496.
Haskins D, Stevens AR Jr, Finch CA: Iron metabolism. Iron stores in man as measured by phlebotomy. J Clin Invest 1952;31:543–547.
- Walters GO, Jacobs A, Worwood M, Trevett D, Thomson W: Iron absorption in normal subjects and patients with idiopathic haemochromatosis: Relationship with serum ferritin concentration. Gut 1975;16:188–192.
Bezwoda WR, Disler PB, Lynch SR, Charlton RW, Torrance JD, Derman D, Bothwell TH, Walker RB, Mayet F: Patterns of food iron absorption in iron-deficient white and Indian subjects and in venesected haemochromatotic patients. Br J Haemtol 1976;33:425–436.
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