Hyperferritinemia in the Chinese and Asian community: a retrospective review of the University of British Columbia experience.
METHODS
Elevated serum ferritin is a common clinical finding. The etiology of hyperferritinemia in the Asia-Pacific population is less clear due to a low prevalence of known HFE mutations such as C282Y and H63D, as well as an increased prevalence of viral hepatitis and hereditary anemia. A retrospective case review of 80 patients of Asian ethnicity referred to three subspecialists in tertiary care teaching hospitals between January 1997 and March 2005 for assessment of hyperferritinemia was performed.


RESULTS
Only four patients (5%) had iron overload on liver biopsy or quantitative phlebotomy. Forty-nine patients (61%) had secondary causes for their hyperferritinemia, of which 26 had liver disease; 16 of those patients also had viral hepatitis. Thirteen patients fulfilled criteria for the insulin resistance syndrome. Other causes included hematological disorders (n=10), malignancy (n=2) and inflammatory arthritis (n=2). Twenty-seven cases (34%) of unexplained hyperferritinemia were found. Of a total of 22 patients who underwent liver biopsy, significant iron deposition was found in one patient. Fifteen patients underwent C282Y and H63D genotyping, with two cases of H63D heterozygosity. Fourteen patients had first-degree relatives with hyperferritinemia. Three families were identified with more than two members affected, which is suggestive of a possible hereditary hyperferritinemia syndrome.


CONCLUSIONS
Secondary causes of elevated ferritin in the Asian population, particularly liver disease, are common, but primary iron overload syndromes appear to be rare. In a significant proportion of patients, the etiology remains unexplained. The genetic basis for hyperferritinemia in Asians is poorly defined and requires further study.
Yenson
Paul R
PR
Division of Hematology, Department of Medicine, University of British Columbia, Vancouver, Canada.
Yoshida
Eric M
EM
Li
Charles H
CH
Chung
Henry V
HV
Tsang
Peter Wk
PW
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D001955:British Columbia / Q000453:epidemiology; D005260:Female; D005293:Ferritins / Q000097:blood*; D005838:Genotype; D006784:Hospitals, Teaching; D006801:Humans; D019190:Iron Overload / Q000175:diagnosis / Q000208:ethnology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D012189:Retrospective Studies
D005293:Ferritins