Is it useful to measure serum ferritin level in systemic lupus erythematosus patients?

• Main Authors: Nada M. Gamal, Tayseer M. Khedr, Nadia M. Ismail, Heba Ramadan, Eman R. Badawy
• Format: Article
• Language: English
• Published: Elsevier 2020-01-01
• Series: Egyptian Rheumatologist
• Online Access: http://www.sciencedirect.com/science/article/pii/S1110116419300535

Background: Serum ferritin is elevated due to various conditions as inflammation and malignancy and could be up regulated in systemic lupus erythematosus (SLE). Aim of work: To evaluate serum ferritin level in SLE patients and correlate it with different clinical and laboratory parameters as well as disease activity. Patients and methods: The study was carried out on 46 SLE patients and 20 matched controls. SLE Disease Activity Index (SLEDAI) was assessed and patients subdivided into severe (SLEDAI ≥ 11) and mild to moderate (SLEDAI < 11) activity. Serum ferritin, iron and total iron binding capacity (TIBC) levels were assessed. Results: They were 40 females and 6 males with a mean age of 36.7 ± 10.3 years and disease duration of 4.9 ± 2.3 years. Serum ferritin was significantly higher in patients than controls (163.5 ± 27.8 vs. 47.1 ± 10.6 ng/ml, p = 0.009). In patients, serum iron (49.2 ± 4.5 mg/dl) and TIBC (284.2 ± 80.8 mg/dl) were comparable with those in controls. Serum ferritin was significantly higher in patients with severe (220.9 ± 50.7 ng/ml) than those with mild-moderate activity (122.9 ± 29.7 ng/ml; p < 0.001). Serum ferritin was significantly higher in patients with anemia (p < 0.001) and thrombocytopenia (p = 0.03) and lower in those with leucopenia (p < 0.001) compared to those without. Ferritin significantly correlated only with hemoglobin (r = 0.5, p = 0.02), platelet count (r = 0.65, p = 0.03) and inversely with leucocytic count (r = −0.08, p = 0.006). Conclusion: Serum ferritin is elevated significantly in SLE patients especially those with severe activity. A remarkable difference in serum ferritin levels in patients with hematological manifestations was found making it a potentially useful inflammatory marker for disease activity in patients with blood dyscrasia. Keywords: Systemic lupus erythematosus, Ferritin, Iron, TIBC, SLEDAI, Hematological