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Significance of extremely elevated ferritin level in medical inpatients

100%
Vardi M., Hogerat T., Cohen S., Cohen S.
Open Medicine
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2014
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vol. 9
|
issue 1
115-120
EN
The diagnostic and prognostic utility of extremely elevated ferritin values in hospitalized medical patients is lacking. We aimed to determine the clinical significance of ferritin levels ≥ 1000 ng/mL in adults hospitalized in the general medical service. We scanned the hospital laboratory database for ferritin values ≥ 1000 ng/mL, and evaluated the medical history, diagnoses, and survival of patients hospitalized in the general medical service. We compared the characteristics and outcomes of patients with values up-to versus above 2,999 ng/mL. Ferritin samples ranging from 1,003 to 12,170 ng/mL from 422 patients in the lower and 94 in the higher ferritin groups were included. Malignancy, repeat blood transfusions and recent chemotherapy were more prevalent in the higher ferritin group (p=0.003, p=0.002, and p<0.001, respectively). Infection (58.7%), chronic kidney disease (22.0%), and solid or hematological malignancies (21.6% and 17.1%, respectively) were the leading conditions associated with elevated ferritin. One-year survival was low, and significantly lower in patients in the higher ferritin group (10.8% vs. 16.9%, p=0.004). In conclusion, extremely elevated ferritin values in patients admitted to the general medical service are associated with multiplicity of clinical conditions and poor outcome.
2
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Prevalence of iron deficiency in male elite athletes

100%
Malczewska-Lenczowska J., Stupnicki R., Szczepańska B.
Biomedical Human Kinetics
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2009
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vol. 1
36-41
EN
Study aim: To assess the prevalence of iron deficiency in competitive male athletes.Material and methods: In total, 90 elite athletes practicing judo, rowing, pentathlon, volleyball, kayaking and biathlon, aged 16-33 years, were studied. Blood morphology indices: haemoglobin concentration (Hb), hematocrit (Hct), red blood cell count (RBC), leucocyte count (WBC), mean corpuscular haemoglobin concentration (MCHC), mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) were determined. The concentrations of ferritin, soluble transferrin receptor (sTfR) and iron, as well as total iron binding capacity (TIBC), were determined in serum. Additionally, erythropoietin (EPO) was assayed in subjects with elevated sTfR levels.Results: In no case iron-deficiency anaemia was found, but in 43% of subjects iron deficiency was detected. This included first stage of iron deficiency (iron depletion; ID) in 13% of subjects (ferritin <20 μg/L), and iron-deficient erythropoiesis (IDE) in 30% of subjects (ferritin <16 μg/L and sTfR> 2.75 mg/L). In all subjects with IDE, the concentrations of EPO were within normal range. The haematological indices remained unaffected in iron-depleted subjects, but in iron-deficient erythropoiesis subgroups the mean values of haemoglobin concentration and hematocrit were significantly lower than in subjects with normal iron stores (NIS).Conclusion: Despite the lack of anaemia among studied athletes, the incidence of latent iron deficiencies (iron depletion and iron-deficient erythropoiesis) was very high. The increasing incidence of iron deficiency, together with apparent decreases of haematological indices in subjects with iron-deficient erythropoiesis, markedly augments the risk of anaemia in young, competitive male athletes. Therefore, that category of subjects should be periodically screened for iron deficiency.
3
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Anticancer Activities of Ferrous and Ferric Ions in Progression, Proliferation, Angiogenesis, Invasion and Metastasis against Cancer and Tumor Cells

63%
Ishida T.
World News of Natural Sciences
|
2018
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vol. 17
111-129
EN
The process of ferroptotic death is characterized by the overwhelming, iron-depending accumulation of lethal lipid ROS. Unlike other forms of apoptotic and non-apoptotic death, this requirement for ROS accumulation appears to be universal. Redox cycling is a characteristic of transition metals such as iron (Ferritin Fe3+ ⇄ Ferrous Fe2+). Iron via the Fenton reaction can exacerbate the consequences of hydrogen peroxide (H2O2) production, leading to the generation of hydroxyl radicals. The superoxide ion can participate in regenerating ferrous iron that is required for the Fenton reaction. An excess of iron is toxic due to its ability to engage in redox cycling and promote free radical formation. Super oxide anion generation; O2 → ･O2－. Hydrogen peroxide production; ･O2－ + 2H+ + e- → H2O2. Haber-Weiss reaction; H2O2 + O2－ → ･OH + OH－ + O2. Fenton reaction; Fe2+ + H2O2 → Fe3+ + OH－ + ･OH. Reduction to Fe(Ⅱ); Fe3+ ＋ ･O2－ → Fe2+ + O2. Ferritin is stable in iron-rich conditions, whereas it is rapidly degraded under conditions of iron starvation and ferritin degradation can be led. New blood vessel formation in angiogenesis is fundamental to tumor growth, invasion, and metastatic dissemination. Iron deficiency will lead to the dysfunction of immune system, metabolic disorders, myasthenia and anemia, whereas, excess iron also damages several vital organs. Thus, iron is essential for multiple cell functions, but is also potentially deleterious reasons of its ability to generate free oxygen radicals, iron balance by continuously recycling and reusing cellular iron, storage in ferritin, and export through ferroportin protecting cells from free iron toxicity. However. the exact molecular mechanism involved on iron imbalance in development for tumor cells and the iron overload-mediated induction of apoptosis are required to be explored in future.
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