In hemochromatosis, both ferritin and iron saturation are increased. Limitations Ferritin escapes from necrotic hepatocytes. In the presence of liver disease, inflammatory diseases such as rheumatoid arthritis, with malignancy or with iron therapy, iron deficiency may not be reflected by low serum ferritin. Ferritin determinations are not reliable in infants on iron therapy. The serum ferritin is, other than a bone marrow examination, the most reliable indicator of total body iron stores.
Ferritin is low with combined iron deficiency and thalassemia.
Very high levels indicate iron overload. Oral and injected iron increase ferritin levels. Increased serum ferritin may be a risk factor in primary hepatocellular carcinoma. 2 Primary hemochromatosis is inherited in an autosomal recessive manner with preliminary evidence that the involved gene is linked to the A locus of the histocompatibility complex on chromosome 6. Red cell ferritin in conjunction with serum ferritin may be useful in distinguishing iron deficiency from iron overload in patients who have -thalassemia.