The Iron Content of Ferritin in Serum and Urine of Children With High Serum Ferritin Levels

A serum ferritin level can reflect the total body iron content, thus a very low serum
ferritin is commonly used as an indicator of iron deficiency and a very high serum ferritin
is commonly used as a marker of iron overload. Ferritin is a shell of protein in which iron
is stored. Ferritin is an acute phase reactant, and serum ferritin levels can increase during
inflammatory conditions. Consequently, an elevated ferritin level might mean there is an
excess of storage iron, or might simply mean that inflammation has resulted in high levels of
the ferritin shell, containing little iron.

The research team is able to quantify the amount of iron in ferritin using inductively
conducted plasma mass spectrometry, in the Heme and Iron Core Laboratory at the University of
Utah. Thus, it can be determined whether in a child with a very high serum ferritin level,
that ferritin is loaded with iron or is actually very low in iron. Neonates and young
children with certain liver disorders characteristically have a very high serum ferritin
level. These conditions are gestational alloimmune liver disease (GALD) and hemophagocytic
lymphohistiocytosis (HLH). It is not clear what the iron content of the ferritin is in these
neonates. Knowing this will be a step toward understanding whether the pathogenesis of these
conditions involves iron overload. Additionally, if urine ferritin and iron levels correlate
with serum ferritin and iron levels, urine may be used as a non-invasive way to monitor iron
status.

In this study, serum and urine samples will be collected from children with high serum
ferritin levels and confirmed iron toxicity. Both ferritin and iron content within ferritin
will be measured in the serum and urine samples and compared for correlation.