Abstract
We aimed to study ferritin as an acute phase marker in pediatric infections, and investigate
its' clinical significance in the emergency department management of the febrile child.
Multiple inflammatory markers, including C-reactive protein, procalcitonin, and serum
ferritin, and other iron studies were measured in 37 children, from 3 months through
8 years of age, presenting to the emergency department with temperature of ≥ 39 degrees
Celsius, and 38 patients in the same age group with non-febrile illness. Mean serum
ferritin was significantly higher in the febrile group 71.4 ng/mL compared to the
non-febrile group 45.1 ng/mL (p < 0.003). Ferritin/iron ratio was 5.28 in the febrile group and 1.72 in the non-febrile
group (p < 0.046). Mean serum iron level was significantly lower in the in Febrile compared
to non-febrile children. Mean serum iron was also significantly lower in the subgroup
of children with bacterial infection: 17.5 μg/dL compared to the group with viral infection 27.1 μg/dL (p < 0.001). The results of this pilot study in the Emergency Department setting confirm
previous work from hospitalized patients indicating that ferritin is increased and
serum iron is decreased in pediatric infections. Further studies are needed to confirm
our findings and to further explore the role of serum iron as a marker of bacterial
infection.
Keywords
Ferritin - serum iron - pediatric infections - iron sequestration
