Diagnosis of hyperferritinemia in 2019

Unlike hypoferritinemia, which almost constantly reflects iron deficiency, hyperferritinemia is often difficult to interpret in the absence of an obvious clinical context. In medical practice, major hyperferritinemia greater than 1000 μg/l is a classic situation. Moore et al. had published in 2013 the results of a 2-year study in a department of internal medicine that found a major hyperferritinemia in 627 patients with the most common causes of cancer [1]. Vardi et al. found similar results with a pejorative prognostic value of severe hyperferritinemia, regardless underlying cause [2]. Another much older study by Lee et al. found similar frequencies of hyperritinemia in the previous two studies with high frequency of etiological associations in the same patients [3]. The high frequency of hyperferritinemia, their wide etiological spectrum and the frequent concomitant presence of several etiologies reflect the need to address hyperferritinemia based on a global vision prioritizing the most obvious and serious causes.