Iron overload and Beta Thalassemia Minor

[Albert76]

Dear doctor,

I would like to ask a question: is it usual or frequent to see high level of ferritin in people with Beta Thalassemia Minor? I am talking about ferritin levels between 600 and 1000 ug / L and even over 1000 ug / L, while the laboratory range is between 30 - 400 ug / L.

Looking forward to hear from you.

Best Regards,
Albert

[Albert76]

On wikipedia I read that Studies have shown that thalassemia minor often  and can cause iron overload of the liver and in those with non-alcoholic fatty liver disease lead to more severe outcomes.

And of course I am worried and that's why I am hear, to listen the opinion of other people who have my same problem, or by doctor or people who know everything about the problem I have.

thanks.

[Albert76]

Thank you very much indeed, Vedadhar.

A couple of years ago I was sent to the hospital by my family doctor because of my alat,Alanine transaminase, was high (144 U/L when the max limit is 45).

At the hospital I underwent to several blood tests, urine tests, abdominal echo and MRI scan to the liver to rule out all the possible underlying causes related to high ALAT levels. The hepatologist concluded that I have a fatty liver due to the fact that I am obese (I am 171 cm tall and my weight is 87kg) and I have BMI, which I already knew since when I was child.

Now I am followed by an haematologist because of my high level of ferritin. Last control the level was 1000 ug/L. In a few days I will have an MRI scan to the liver because the doctor want to see how much iron is in the liver and then the doctor will likely put me on medications trying to reduce the iron level.

I have to say that I notice that when I do some diet and lose some weight, ALAT and ferritin levels improve but as I eat a bit more and gain some weight again, those two values get worse.

On wikipedia I read that <>

Now of course I am very worried and I start to wonder if it is possible that such high levels of ferritin, I have, can be related to BMI or maybe there is something else that is causing this and doctors are not able to locate.

Thank you,
Albert

[Albert76]

Thank you very much indeed for your answer Dr. Sclafani,

One more question: Is what you just said (often times ferritin is elevated up to values of 2000 to 4000 ng/mL) also observed in cases of Minor type of Beta Thalassemia (BTM)?

Thank you,

Sincerely,
Albert

[Joseph Sclafani, M.D.]

Hello, thank you for your question.

Patients with beta thalaseemia may absorb increased amounts of iron to the point where they may have clinical iron overload.

Often times the serum ferriting is markedly elevated up to values of 2000 to 4000 ng/mL (normal 40 to 200 ng/mL).

Very Respectfully,
Dr. S

[vedadhar]

Serum ferritin test is done for evaluating iron deficiency anemia.The ferritin levels measured usually have a direct correlation with the total amount of iron stored in the body. However, ferritin levels may be artificially high in cases of anemia of chronic disease where ferritin is elevated in its capacity as an acute phase protein and not as a marker for iron overload.

So this is not the diagnostic test for testing the progression of Beta Thalassemia Minor.Thalaseemias are required to have a modest anemia with hematocrit between 28% and 40%. The MCV ranges from 55 fL to 75 fL, and the red blood cell count is normal or increased. The reticulocyte count is normal or slightly elevated.Hemoglobin electrophoresis shows an elevation of hemoglobin A2 to 4–8% and occasional elevations of hemoglobin F to 1–5%.

Patients having BTM may have problems about regulation of iron absorption.The first factor consists of the degree of impaired red-blood cell production that has taken place within the body. The second factor respectively correlates with the degree of iron overload within the blood.Since iron loading depends on the volume of blood transfused and the amount of iron accumulated from the food displaced in the gut, these factors are significantly important in the regulation of total iron absorption within the human body.

High levels of Ferritin may indicate to recognize affected pathology as liver, heart and endocrine glands are frequently involved.It helps to diagnose Secondary haemochromatosis,which is important in management of BTM.

It is unusual for BTM patients to have high levels of ferrtin,but who have such ranges, it suggests the progression of disease and prolongation of associated disorders.This test is done to identify cases of severe thalassemias who may require blood transfusion or management of other systemic pathology.Patients within normal ranges generally do not require further treatment but should be frequently test to ***** the severity or progression of prolonged symptoms.

Hope this explanation clears your doubt.