Suspected iron overload or high serum ferritin

Published on 09/04/2015 by admin

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Last modified 09/04/2015

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Chapter 37 SUSPECTED IRON OVERLOAD OR HIGH SERUM FERRITIN

IRON METABOLISM

Iron is present at about 35–45 mg/kg body weight in men and women respectively (typically 2–3 g). Iron uptake in the gut is the key step regulating iron stores and is stimulated by iron deficiency and chronic anaemia. Approximately 10%–20% of dietary iron (1–2 mg/day) is absorbed in the proximal small intestine. Once in enterocytes, iron needs to be released into the circulation, where it complexes with transferrin to be transported around the body. Iron is used in a variety of essential proteins including haemoglobin (60%–70% of body stores); and myoglobin, cytochromes and other cellular enzymes (10% of body stores). The liver is the principal storage site for iron (typically 20%–30% of body stores), in protein, ferritin; and in haemosiderin, where it can be detected histologically with Perl’s stain. Iron is lost from the body (about 1 mg/day) in bile and urine, and with the shedding of enterocytes and skin. In women, iron is also lost with menses and pregnancy. In pathological states, iron can be depleted by gastrointestinal blood loss and excessive menstrual losses.

Causes of high serum ferritin

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