CLINICAL INVESTIGATIONS OF SERUM FERRITIN IN VARIOUS LIVER DISEASES

Abstract

Serum ferritin levels were determined in 487 cases of various liver diseases. Follow up study of ferritin for more than 6 months in 195 cases showed that there were 5 types in its change: type I was that fluctuated within normal range, type II changed from normal to the levels less than 1000ng/ml, type III changed from normal to more than 1000ng/ml, type IV was always in abnormal high levels and type V gradually increased to abnormal levels.
Almost all patients in chronic inactive hepatitis belonged to type I, while chronic active hepatitis to type II to IV. Four of 6 patients of type IV progressed to liver cirrhosis. Serum ferritin levels in decompensated liver cirrhosis more fluctuated than those in compensated cases. Hepatic failure occured frequently in cases whose ferritin remained high levels. These results suggested that continuously high levels of ferritin reflected progressive hepatic cell damages and prognostic evaluation could be obtained from the follow up of ferritin. On the other hand, most patients with liver cirrhosis who transformed to hepatocellular carcinoma (HCC) belonged to type I. Moreover, serum ferritin increased after resection of the tumor or injections of anticancer agents to the tumor and returned to normal levels with relatively long period. Thus, measurements of serum ferritin were less valuable in detecting or monitoring HCC when compared with assay of α-fetoprotein.