Serum ferritin levels may not be a useful indicator of iron-deficiency anemia in patients with which conditions?

Serum ferritin levels may not be a useful indicator of iron-deficiency anemia in patients with which conditions?

• A. Chronic infection
• B. Malignancy
• C. Viral hepatitis
• D. All the above

Answer: (D)

Serum ferritin is both a storage form of iron and an acute-phase protein that rises during inflammation. In chronic infection, cancer, or liver inflammation from viral hepatitis, inflammatory cytokines stimulate ferritin production and release, and liver injury can release ferritin. This means ferritin levels can be normal or elevated even when iron stores are depleted, making ferritin a poor standalone indicator of iron-deficiency anemia in these settings. Because of that, ferritin alone can’t reliably distinguish iron deficiency when inflammation or liver disease is present, so all of these conditions can blunt its usefulness.

Serum ferritin is both a storage form of iron and an acute-phase protein that rises during inflammation. In chronic infection, cancer, or liver inflammation from viral hepatitis, inflammatory cytokines stimulate ferritin production and release, and liver injury can release ferritin. This means ferritin levels can be normal or elevated even when iron stores are depleted, making ferritin a poor standalone indicator of iron-deficiency anemia in these settings. Because of that, ferritin alone can’t reliably distinguish iron deficiency when inflammation or liver disease is present, so all of these conditions can blunt its usefulness.