title: [Diagnosis of an increased serum level of ferritin].
abstract: The discovery of a hyperferritinemia is most of the time fortuitous. The diagnostic approach aims at looking for the responsible etiology and at verifying if an iron hepatic overload is present or not. Three diagnostic steps are proposed. The clinical elements and a few straightforward biological tests are sufficient at first to identify one of the four main causes: alcoholism, inflammatory syndrome, cytolysis, and metabolic syndrome. None of these causes is associated with a significant iron hepatic overload. If the transferring saturation coefficient is raised (>50%) a hereditary hemochromatosis should be discussed. Secondly, less common disorders will be discussed. Among these, only the chronic hematological disorders either acquired or congenital are at risk of iron hepatic overload. Thirdly, if a doubt persists in the etiologic research, and the serum ferritin level is very high or continues to rise, it is essential to verify that there is no iron hepatic overload. For that purpose, the MRI with study of the iron overload is the main test, which will guide the therapeutic attitude. Identification of more than a single etiology occurs in more than 40% of the cases.
authors: Service de médecine interne et immunologie clinique, hôpital du Bocage, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France. Electronic address: bernard.lorcerie@chu-dijon.fr.
authors: B
authors: B
authors: Lorcerie
authors: Service de médecine interne et immunologie clinique, hôpital du Bocage, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France.
authors: S
authors: S
authors: Audia
authors: Service de médecine interne et immunologie clinique, hôpital du Bocage, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France.
authors: M
authors: M
authors: Samson
authors: Service de médecine interne et immunologie clinique, hôpital du Bocage, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France.
authors: A
authors: A
authors: Millière
authors: Service de médecine interne et immunologie clinique, hôpital du Bocage, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France.
authors: N
authors: N
authors: Falvo
authors: Service de médecine interne et immunologie clinique, hôpital du Bocage, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France.
authors: V
authors: V
authors: Leguy-Seguin
authors: Service de médecine interne et immunologie clinique, hôpital du Bocage, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France.
authors: S
authors: S
authors: Berthier
authors: Service de médecine interne et immunologie clinique, hôpital du Bocage, CHU de Dijon, 2, boulevard du Maréchal-de-Lattre-de-Tassigny, BP 77908, 21079 Dijon cedex, France.
authors: B
authors: B
authors: Bonnotte
mesh_terms: D005293:Ferritins / Q000097:blood*; D006801:Humans; D019189:Iron Metabolism Disorders / Q000097:blood* / Q000150:complications / Q000175:diagnosis* / Q000209:etiology
chemical_list: D005293:Ferritins
keywords: Alcoholism; Alcoolisme; Cytolyse; Cytolysis; Hepatic MRI; Hereditary hemochromatosis; Hyperferritinemia; Hyperferritinémie; Hémochromatose héréditaire; IRM hépatique; Inflammatory syndrome; Metabolic syndrome; Syndrome inflammatoire; Syndrome métabolique