Hyperferritinemia in a kidney transplant recipient

Abstract

The principal iron storage protein is ferritin, which is primarily present in cytoplasm. The most common cause of hyperferritinemia is iron overload, which is either primary or secondary. Hyperferritinemia is commonly found in patients with chronic kidney disease regardless of their hemoglobin level and is often considered to be related to chronic inflammatory status as well as malnutrition and neoplasias. We present a case of a kidney transplant patient that developed severe hyperferritinemia associated with liver dysfunction. In our patient, high hyperferritinemia was detected a year after transplantation, when she had no signs of inflammation. Malignancies, chronic viral hepatitis, and chronic inflammatory disease were also excluded as the causes of hyperferritinemia. Since high serum ferritin levels were combined with increased transferrin saturation and mildly elevated plasma iron concentrations, we presume that the most probable cause of hyperferritinemia in our patient was iron overload.