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Test Code FERR Ferritin, Serum

Reporting Name

Ferritin, S

Useful For

Aiding in the diagnosis of iron deficiency and iron overload conditions

 

Differentiating iron deficiency anemia and anemia of chronic disease

Testing Algorithm

See Hereditary Hemochromatosis Algorithm in Special Instructions.

Performing Laboratory

Mayo Medical Laboratories in Rochester

Specimen Type

Serum


Specimen Required


Container/Tube:

Preferred: Serum gel

Acceptable: Red top

Specimen Volume: 0.6 mL

Collection Instructions:

1. Serum gel tubes should be centrifuged within 2 hours of collection.

2. Red-top tubes should be centrifuged and aliquoted within 2 hours of collection.


Specimen Minimum Volume

0.5 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Refrigerated (preferred) 7 days
  Frozen  90 days

Reference Values

Males: 24-336 mcg/L

Females: 11-307 mcg/L

Day(s) and Time(s) Performed

Monday through Friday, Sunday

Test Classification

This test has been cleared or approved by the U.S. 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.

CPT Code Information

82728

LOINC Code Information

Test ID Test Order Name Order LOINC Value
FERR Ferritin, S 20567-4

 

Result ID Test Result Name Result LOINC Value
FERR Ferritin, S 20567-4

Clinical Information

Ferritin is a large spherical protein consisting of 24 noncovalently linked subunits with a molecular weight of approximately 450,000 daltons. The subunits form a shell surrounding a central core containing variable amounts of ferric hydroxyphosphate. One molecule of ferritin is capable of binding between 4,000 and 5,000 atoms of iron, making ferritin the major iron storage protein for the body.

 

Ferritin is found chiefly 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 males. There is a significant positive correlation between age and serum ferritin concentrations in females, but not in males.

 

Patients with iron deficiency anemia have serum ferritin concentration approximately one-tenth of normal subjects, while patients with iron overload (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 renal failure, and in some types of neoplastic disease.

 

Evaluating body iron stores may include serum iron determination, total iron binding capacity (TIBC), and percent saturation of transferrin, however 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).

Interpretation

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 1,000 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 in Special Instructions.

Clinical Reference

1. Henry's Clinical Diagnosis and Management by Laboratory Methods. 21st edition. Edited by RA McPherson, MR Pincus.Philadelphia. Elsevier Saunders, 2007, pp 506

2. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. Edited by CA Burtis, ER Ashwood, DE Bruns. St. Louis, MO, Elsevier Saunders, 2012, pp 985-1030

Analytic Time

Same day/1 day

Reject Due To

Hemolysis

Mild OK; Gross reject

Lipemia

Mild OK; Gross OK

Icterus

NA

Other

NA

Method Name

Immunoenzymatic Assay