Thread by @nihardesai7

#FERRITIN is being widely ordered these days. Let's dive into the details and learn more about this protein. A short thread for those interested. Covers some history, biology and practical aspects about FERRITIN.

1/n

It was discovered in 1937 by Laufbérger but it wasn't until 1972 that an assay was devised to measure serum ferritin.

Ferritin is present in 2 forms
👉 Intra-cellular (in the cytosol)
👉 Extra-cellular

2/n

It is a ~450kDa protein.
Has 24 subunits of 2 major types
👉 H : gene on chr 11q
👉 L : gene on chr 19q

Serum ferritin has ⬆️ L: H ratio.

3/n

The source of ferritin is not exactly known. Hepatocytes, macrophages etc are postulated to be the source.

Ferritin is the major STORAGE IRON form and serves as a surrogate MARKER for total body iron stores.

4/n

Normal serum values: 30-300 ng/ml

⬇️⬇️ferritin:
1 Iron def anemia
2 Hypothyroidism
3 Ascorbate defeciency

⬆️⬆️Ferritin has many causes:
1 Transfusion iron overload
2 Hereditary Hemsiderosis
3 Inflammation
4 Cancer
5 HLH/MAS cause extreme elevation.

5/n

Low ferritin is quite specific for iron def anemia but⬆️⬆️Ferritin ≠ iron overload always. Inflammation etc lead to chronically ⬆️Ferritin levels.

#COVID19 causes⬆️Ferritin because of the inflammatory cytokines.

6/n

Remember that ⬆️⬆️Ferritin ISN'T THE ONLY CRITERIA FOR HLH. There are 7 more !!

7/7

@HaryaxPathak @pankti4299 @PanktiMehta24 @AlishaAkhani @hard_dil @scalpel_heals @viswas_mr @DevPalkar @shreya__kataria @docsamdeshmukh #COVID19 #CoronaPandemic