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Causes of Hyperferritinemia and Red Blood Cell Transfusion
고페리틴혈증의 원인과 적혈구 수혈
Korean J Blood Transfus 2018;29:273−281
Published online December 31, 2018;
© 2018 The Korean Society of Blood Transfusion.

Mi Seon, Kim1, Sun Hyung Kim2,3

Graduate School, Jeju National University School of Medicine1, Department of Laboratory Medicine, Jeju National University School of Medicine2, Department of Laboratory Medicine, Jeju National University Hospital3, Jeju, Korea
제주대학교 의학전문대학원1, 제주대학교 의학전문대학원 진단검사의학교실2, 제주대학교병원 진단검사의학과3
Sun Hyung Kim
Department of Laboratory Medicine, Jeju National University School of Medicine and Jeju National University Hospital, 15 Aran 13-gil, Jeju 63241, Korea
Tel: 82-64-717-1458, Fax: 82-64-717-1457, E-mail:, ORCID:
Received July 19, 2018; Revised November 9, 2018; Accepted November 17, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: Ferritin is used to detect iron overload in patients with chronic red blood cell transfusions. Although ferritin reflects the amount of iron storage in the body, it may increase nonspecifically in inflammation and infection. This study analyzed the cause of increased ferritin and the association with a red blood cell (RBC) transfusion.
Methods: The medical records of patients who visited the authors’ hospital from January to December 2017 and underwent a ferritin test were reviewed retrospectively. Hyperferritinemia was defined as a ferritin level more than 1,000 ng/mL. The causes of hyperferritinemia were investigated by examining the laboratory findings and medical records.
Results: The results revealed 417 cases of hyperferritinemia in 238 patients during the period. The most common diseases were hematologic malignancies from 125 cases (30.0%) in 31 patients and infectious diseases were the second most common. Iron overload was suspected in 119 cases in 33 patients, and 12 patients (76 cases) were transfused with more than 8 units of RBC for 1 year before the test.
Conclusion: In hyperferritinemia, the rate of iron overload is high considering the underlying diseases and chronic RBC transfusion. To determine iron storage status accurately, it will be helpful to measure the C-reactive protein (CRP) and iron saturation in the ferritin test. Careful attention should be paid to habitual iron formulations and frequent transfusions due to the possibility of iron overload.
Keywords : Hyperferritinemia, Iron overload, Red blood cell, Transfusion


December 2018, 29 (3)
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