[NPInfo] Ferritin levels

[jamestblackwell at aol.com]

I agree with Peg.? However, as Peg has said, a high ferritin with no anemia may also be indicative of an inflammatory state such as neoplasms (i.e., metastatic cancers, lymphomas, leukemias), collagen diseases/inflammatory disorders, and alcoholics along with iron excess states such as recent blood transfusions or chronic anemics (i.e., sickle cell or B-thal patients) who are on iron supplementation (this would make their Hgb nl, but elevate their ferritin.? I know this isn't right, but we still see these types of patients referred to us).? I would also look a peripheral blood smear and retic count to look at what the bone marrow is doing.? 

James Blackwell, NP
Heme/Onc

-----Original Message-----
From: Margaret A. Fitzgerald, DNP, NP-C, APRN, BC, FAANP, CSP <pegf at hotmail.com>
To: NP Info <npinfo at nurse.net>
Sent: Sun, 10 Feb 2008 6:09 pm
Subject: RE: [NPInfo] Ferritin levels



Hello- Re: NL to high Fe with low ferritin. Since serum iron is essentially a 
drug level measurement, ingestion of any iron supplement within 24 hours of the 
test creates a normal or even increased level in the presence of an iron 
deficiency anemia. Treat the low ferritin in this case.
 
When ferritin is high but there is no anemia: Recall that ferritin can also be a 
non specific measure of inflammation, similar to CRP or ESR. Look an underlying 
inflammation or liver disease as the case for this elevation. 
Dr. Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP President, Fitzgerald 
Health Education Associates, Inc. 85 Flagship Drive North Andover, MA 01845-6154 
978.794.8366 FHEA website www.fhea.com FHEA on line store www.fhea.biz 
peg at fhea.com
FNP, Adjunct Faculty, Family Practice Residency Greater Lawrence (MA) Family 
Health Center, Inc.

> From: GAAdams at aol.com> Date: Sat, 9 Feb 2008 14:24:59 -0500> To: 
npinfo at nurse.net> Subject: [NPInfo] Ferritin levels> > This question is for Peg 
or for anyone with hematology expertise.> I am confused with what to do for 
patients with low ferritin levels yet ok > to high Fe levels. What can you do to 
boost their stores? Also what about > those that have the opposite high ferritin 
levels greater than 200 or maybe > even 300+ with normal or even low Fe levels? 
TIA> Gaylene > > > > **************Biggest Grammy Award surprises of all time on 
AOL Music. > (http://music.aol.com/grammys/pictures/never-won-a-grammy?NCID=aolcmp003000000025> 
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