Table 1.
Reported pathological roles of ferritin in iron overload conditions; eg, thalassemia
| In thalassemic patients without hepatitis viral infection: |
| High serum ferritin is: |
| • An index of liver iron overload in thalassemia patients (not having viral hepatitis or ascorbic acid deficiency).78 |
| • Associated with immunological suppression.48 |
| • Associated with increased growth rates of cancer cells and infectious organisms.48 |
| In thalassemic patients with hepatitis viral infection: |
| High serum ferritin is: |
| • Closely related to the liver iron concentration. Adequate chelation therapy usually protects against liver fibrosis.79 |
| • Useful in the follow-up of patients receiving long-term transfusional treatment using the ferritin/ALT ratio, especially when acute or chronic liver cell damage may interfere with iron overload by increasing serum ferritin values.80 |
| • Associated with hepatitis C virus infection (causing raised AST activity and serum ferritin concentration compared with seronegative patients).81 |
| • Significantly associated with the hepatic fibrosis.82 |
| • A risk factor (with serum triglycerides and total cholesterol) for impaired glucose tolerance and diabetes mellitus.83 |
| • Associated with hepatitis C virus antibody positivity and HCV-RNA by PCR.84,85 |
| • Associated with high liver transaminases (ALT, AST), anti-HCV seropositivity, raised liver transaminases, hemochromatosis status, and liver fibrosis.84–89 |
| • Associated with viral hepatitis (genotype 1) with higher rate of splenectomy.90 |
| • Observed in patients with TTV-HCV coinfection compared with patients with TTV infection alone.91 |
| • Accounting in part for the enlargement of hepatoduodenal ligament nodes in thalassemia.92 |
| Low serum ferritin is: |
| • Associated with sustained virological response to ribavirin.93 |
| • Reported in complete responders to interferon therapy compared with the values for partial and nonresponders before starting therapy.94 |
| • Observed in patients who responded to interferon-alpha monotherapy.95 |
Abbreviations: ALT, alanine aminotransferase; AST, aspartate aminotransferase; HCV, hepatitis C virus; PCR, polymerase chain reaction; RNA, ribonucleic acid; TTV, Torque teno virus.