Iron saturation increases earlier in the development of
iron overload and until the ferritin levels start to rise one can
assume that there is no significant tissue iron overload since in most
cases a normal ferritin suggests that iron stores are not increased.
However there are rare exceptions. Some families have been reported
where serum ferritin was normal in the presence of markedly increased
liver iron [Bailliere's Clinical haematology April 1989; 2(2):
363-389. relevent page 371]. Did the index case in the family have a
raised serum ferritin?. Apparently another report claims that 5% of
family members of patients with haemochromatosis show this discrepancy
(Lancet 1997 ii 621-624).
> Reply-to: [log in to unmask]
> Subject: Ferritin a good marker?
> People from the department of internal medicine have confonted me with
> the following question. A young woman born in 1971 has a family history
> of hereditary hemochromatosis which is confirmed for her as being
> homozygous(Cys282Tyr).Her liver enzymes are still normal. Her serum Fe
> is 56 umol/l and her TIBC is 62 umol/l. Her serm ferritin is 49 umol/l
> (ref range 10 - 130).
> Does the normal ferritin mean there is no storage of iron in the liver
> or other organs or can there be a reason for "false normal values"
> Who can help me with this question.
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