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Extreme hyperferritinaemia; clinical causes
  1. Martin A Crook1,2,3,4,
  2. Patrick L C Walker5
  1. 1Department of Clinical Biochemistry and Metabolic Medicine, University Hospital Lewisham, London, UK
  2. 2Department of Clinical Biochemistry and Metabolic Medicine, Guy's Hospital, London, UK
  3. 3Department of Clinical Biochemistry and Metabolic Medicine, St Thomas’ Hospital, London, UK
  4. 4Department of Clinical Biochemistry and Metabolic Medicine, University of Greenwich, London, UK
  5. 5St. George's, University of London, London, UK
  1. Correspondence to Dr MA Crook, Department of Clinical Biochemistry University Hospital Lewisham, London SE13 6LH, UK; m.crook{at}


There are many causes of raised serum ferritin concentrations including iron overload, inflammation and liver disease to name but a few examples. Cases of extreme hyperferritinaemia (serum ferritin concentration equal to or greater than 10 000 ug/l) are being reported in laboratories but the causes of this are unclear. We conducted an audit study to explore this further. Extreme hyperferritinaemia was rare with only 0.08% of ferritin requests displaying this. The main causes of extreme hyperferritinaemia included multiple blood transfusions, malignant disease, hepatic disease and suspected Still's disease.

  • Chemical Pathology
  • Iron Metabolism
  • Liver
  • Inflammation

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