title: Dysmetabolic hyperferritinemia: all iron overload is not hemochromatosis.
abstract: Disturbances in iron metabolism can be genetic or acquired and accordingly manifest as primary or secondary iron overload state. Organ damage may result from iron overload and manifest clinically as cirrhosis, diabetes mellitus, arthritis, endocrine abnormalities and cardiomyopathy. Hemochromatosis inherited as an autosomal recessive disorder is the most common genetic iron overload disorder. Expert societies recommend screening of asymptomatic and symptomatic individuals with hemochromatosis by obtaining transferrin saturation (calculated as serum iron/total iron binding capacity × 100). Further testing for the hemochromatosis gene is recommended if transferrin saturation is >45% with or without hyperferritinemia. However, management of individuals with low or normal transferrin saturation is not clear. In patients with features of iron overload and high serum ferritin levels, low or normal transferrin saturation should alert the physician to other - primary as well as secondary - causes of iron overload besides hemochromatosis. We present here a possible approach to patients with hyperferritinemia but normal transferrin saturation.
authors.affiliation: Division of Gastroenterology, Albert Einstein College of Medicine of Yeshiva University, Bronx, N.Y., USA ; Department of Medicine, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine of Yeshiva University, Bronx, N.Y., USA.
authors.forename: Jasbir
authors.initials: J
authors.lastname: Makker
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine of Yeshiva University, Bronx, N.Y., USA.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Hanif
authors.affiliation: Department of Medicine, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine of Yeshiva University, Bronx, N.Y., USA.
authors.forename: Bharat
authors.initials: B
authors.lastname: Bajantri
authors.affiliation: Division of Gastroenterology, Albert Einstein College of Medicine of Yeshiva University, Bronx, N.Y., USA ; Department of Medicine, Bronx Lebanon Hospital Center, Albert Einstein College of Medicine of Yeshiva University, Bronx, N.Y., USA.
authors.forename: Sridhar
authors.initials: S
authors.lastname: Chilimuri
keywords: Dysmetabolic hyperferritinemia; Hemochromatosis; Hyperferritinemia; Iron overload; Transferrin saturation