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Comment & Response
December 17, 2014

Causes of Ferritin Elevation

Author Affiliations
  • 1Division of Gastroenterology and Hepatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois

Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.

JAMA. 2014;312(23):2572. doi:10.1001/jama.2014.14964

In Reply Dr Lippi raises the important point that an elevated serum ferritin level may also be associated with underlying malignancy; it is true that ferritin may be elevated in a broad variety of other disease processes, as we noted in our JAMA Diagnostic Test Interpretation article. Elevated serum ferritin levels are commonly encountered in general practice and many elevations may be due to non–iron overload conditions.

The patient described was a relatively healthy middle-aged man who was unexpectedly noted to have a markedly elevated ferritin level. The cited investigation by Moore et al1 retrospectively studied the underlying etiology of markedly elevated serum ferritin levels in a large group of patients at a tertiary care medical center, including patients with a range of cancers, infections, inflammatory conditions, and renal diseases.1 This study population is distinctly different from the relatively healthy patient described in our article.

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