Erythrocyte and plasma ferritin in normal subjects, blood donors and iron deficiency anemia patients

Abstract

Ferritin concentration has been determined with an immunoradiometric assay in plasma and washed sedimented erythrocytes after hypotonic lysis. There was a gradual decrease of plasma ferritin in the sequence normal males, normal females, blood donors and patients with iron deficiency anemia. Erythrocyte ferritin remained unchanged in normal males and females and in blood donors, but dropped significantly in the anemic patients. Correspondingly, the ratio of erythrocyte to plasma ferritin rose from less than 2 in healthy males up to 8 in persons with iron deficiency. Little, if any effect on plasma and erythrocyte ferritin was observed in 12 male and female volunteers when taking iron for 4 weeks. In 2 patients with iron deficiency anemia the blood counts were normalized within 2-3 months during oral iron substitution, accompanied by a drastic increase of the erythrocyte ferritin concentration to values far above normal. In contrast, the plasma ferritin concentration remained below normal. Thus, in iron deficiency erythrocyte ferritin is synthesized with priority in the presence of iron and, in addition to plasma ferritin, appears to be a useful parameter of the iron status.

Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells

“…Thus, importantly, ferritin is made in cells (including intestinal cells), and not in serum. We also note the evidence for the presence of ferritin within erythrocytes, [40][41][42][43][44][45][46][47][48][49][50][51][52][53][54] the largest volume fraction of serum. 55 In nucleated cells, ferritin resides mainly in the cytoplasm, but there are nuclear [56][57][58][59][60][61] and mitochondrial [62][63][64] forms (not considered here, as our focus is serum ferritin).…”

“…440,441 Correlation of platelet microparticles with serum ferritinfurther evidence for the cell damage hypothesis As mentioned, a considerable number of papers note the presence of ferritin in erythrocytes, the largest cellular compartment in blood. 40,[43][44][45][46][47][48][49][50]53,54 In RBCs, one of the more notable cell death mechanisms is eryptosis, a suicidal death of erythrocytes; this is characterized by erythrocyte shrinkage, blebbing, and phospholipid scrambling of the cell membrane. There is limited evidence that eryptosis occurs in iron overload conditions like b-thalassemia.…”

Assessment of Iron Status with a New Fully Automated Assay for Transferrin Receptor in Human Serum

“…The other investigated biochemical parameters included serum iron (Ferene S technique), transferrin (BNII immunonephelometer), the coefficient of saturation of transferrin, serum ferritin (BNII immunonephelometer), and erythrocyte ferritin (15). The blood picture was ascertained -with a SYSMEX SE-9000 (Toa Medical Electronics, Kobe, Japan) -in all subjects except those suffering from hemochromatosis.…”

The usefulness of serum transferrin receptor and ferritin for assessing anemia in rheumatoid arthritis: comparison with bone marrow iron study

“…Serum ferritin has been used as the most reliable indicator of iron de®ciency in the general population [22]. However, in patients with chronic liver disease, chronic in¯ammation, and malignant tumor, ferritin concentration is higher than normal, since it acts as an acute phase reactant [4].…”