Aiding in the diagnosis of iron deficiency and iron overload conditions
Differentiating iron deficiency anemia and anemia of chronic disease
For more information see Hereditary Hemochromatosis Algorithm.
Electrochemiluminescence Immunoassay
Ferritin, Serum
For more information see Hereditary Hemochromatosis Algorithm.
Serum
Patient Preparation: For 12 hours before specimen collection, patient should not take multivitamins or dietary supplements (eg, hair, skin, and nail supplements) containing biotin (vitamin B7).
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container Tube: Plastic vial
Specimen Volume: 0.6 mL
Collection Instructions: Within 2 hours of collection, centrifuge and aliquot serum into a plastic vial.
0.5 mL
Gross hemolysis | Reject |
Gross lipemia | OK |
Gross icterus | Reject |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Serum | Refrigerated (preferred) | 7 days | |
Frozen | 365 days | ||
Ambient | 24 hours |
Aiding in the diagnosis of iron deficiency and iron overload conditions
Differentiating iron deficiency anemia and anemia of chronic disease
For more information see Hereditary Hemochromatosis Algorithm.
Ferritin is a large spherical protein consisting of 24 noncovalently linked subunits with a molecular weight of approximately 450,000 Da. The subunits form a shell surrounding a central core containing variable amounts of ferric hydroxyphosphate. One molecule of ferritin is capable of binding between 4000 and 5000 atoms of iron, making ferritin the major iron storage protein for the body.
Ferritin is found mainly in the cytoplasm of cells of the reticuloendothelial system and is a constituent of normal human serum. The concentration of ferritin is directly proportional to the total iron stores in the body, resulting in serum ferritin concentrations becoming a common diagnostic tool in the evaluation of iron status.
In most normal adults, serum ferritin concentrations vary with age and sex. There is a sharp rise in serum ferritin concentrations in the first month of life, coinciding with the depression of bone marrow erythropoiesis. Within 2 or 3 months, erythropoiesis becomes reactivated and there is a drop in the concentration of serum ferritin. By 6 months, the concentration is reduced to fairly low levels, where they remain throughout childhood. There is no sex difference until the onset of puberty, at which time ferritin concentrations rise, particularly in male patients. There is a significant positive correlation between age and serum ferritin concentrations in female patients but not in male patients.
Patients with iron deficiency anemia have serum ferritin concentrations approximately one-tenth of normal subjects, while patients with iron overload conditions (hemochromatosis, hemosiderosis) have serum ferritin concentrations much higher than normal. Studies also suggest that serum ferritin provides a sensitive means of detecting iron deficiency at an early stage. Serum ferritin concentrations may serve as a tool to monitor the effects of iron therapy, but results should be interpreted with caution as these cases may not always reflect the true state of iron stores. Ferritin is a positive acute phase reactant in both adults and children, whereby chronic inflammation results in a disproportionate increase in ferritin in relation to iron reserves. Elevated ferritin is also observed in acute and chronic liver disease, chronic kidney failure, and in some types of neoplastic disease.
Evaluating body iron stores may include serum iron determination, total iron binding capacity, and percent saturation of transferrin, however, these are subject to diurnal variations and may be less precise. Additionally, they do not discriminate between depleted iron stores (iron deficiency) and conditions associated with defective iron release (eg, anemia of chronic disease).
Males:
0 days-4 weeks: 150-973 mcg/L
5 weeks-5 months: 9-580 mcg/L
6 months-9 years: 6-111 mcg/L
10-17 years: 15-201 mcg/L
> or =18 years: 31-409 mcg/L
Females:
0 days-4 weeks: 150-973 mcg/L
5 weeks-5 months: 9-580 mcg/L
6 months-17 years: 8-115 mcg/L
18-50 years: 6-175 mcg/L
> or =51 years: 11-328 mcg/L
Hypoferritinemia is associated with increased risk for developing iron deficiency where iron deficiency is sufficient to reduce erythropoiesis causing hemoglobin concentrations to fall. Latent iron deficiency occurs when serum ferritin is low without low hemoglobin.
Hyperferritinemia is associated with iron overload conditions including hereditary hemochromatosis where concentrations may exceed 1000 mcg/L. Non-iron overload hyperferritinemia may be caused by common liver disorders, neoplasms, acute or chronic inflammation, and hereditary hyperferritinemia-cataract syndrome.
For more information about hereditary hemochromatosis testing, see Hereditary Hemochromatosis Algorithm.
Ferritin is an acute phase reactant and may be elevated in patients with inflammation, liver disease, chronic infection, autoimmune disorders, and malignancy.
Ferritin may be elevated in excess iron storage disorders besides hemochromatosis including hemolytic anemia, sideroblastic anemia, and in those with multiple blood transfusions.
Race and ethnicity factors (especially in Africans, African Americans, and Asians) are also associated with higher mean concentrations of serum ferritin than are typical of the White population, the basis of which is not completely understood.
1. McPherson RA, Pincus MR: Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st ed. Elsevier Saunders; 2007:506
2. Burtis CA, Ashwood ER, Bruns DE: Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Elsevier Saunders; 2012:985-1030
3. Cappellinin MD, Lo SF, Swickels DW: Hemoglobin, iron, bilirubin. In: Rifai N, Horvath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier Saunders; 2018:719-775
Monday through Sunday
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.
82728
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
FERR1 | Ferritin, S | 20567-4 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
FERR1 | Ferritin, S | 20567-4 |