Background: High levels of Serum ferritin are not usual in patients without iron overload. Such condition can be seen in patients with cancer, liver disease or infections, and also can be one of the presentations of a syndrome. In all these condition iron overload cannot be detected and high levels of ferritin dose not mean the lack of iron depletion or iron defiiency anemia and are exclusively related to inflammation. Case Report: In this article, a patient is introduced without any history of multiple transfusion and iron overload, with high levels serum ferritin during the process of an infection disease, while she had a moderate iron deficiency anemia. Conclusion: According to underlying disease and serum ferritin levels in the patient and review of related articles seems that serum ferritin like the CBC, CRP and ESR can act as acute phase reactant so it increase at severity phase of infection and decreased with treatment of it.

BACKGROUND: Plasma iron excess can lead to iron accumulation in heart, kidney and liver. Heart failure is a clinical widespread syndrome. In thalassemia, iron overload cardiomyopathy is caused by iron accumulation in the heart that leads to cardiac damage and heart failure. Digoxin increases the intracellular sodium concentration by inhibition of Na+/K+-ATPase that affects Na+/Ca2+ exchanger (NCX), which raises intracellular calcium and thus attenuates heart failure. The mechanism of iron uptake into cardiomyocytes is not exactly understood.METHODS: We assessed the effect of different concentrations of digoxin on cardiac iron content in rat model of iron overload. Digoxin had been administrated intraperitoneally (IP) for one week before main study began to assure increased digoxin levels. Group 1 received four IP injections of iron-dextran (12.5mg/100g body weight) every 5 days evenly distributed over 20 days. Groups 2-4 received 0.5, 1 and 5 mg/kg/day IP digoxin, respectively. Last three groups 5-7 received irondextran as group 1 and digoxin concentrations 0.5, 1 and 5 mg/kg/day, respectively.RESULTS: Cardiac iron contents were significantly higher in iron overload groups that received different concentrations (0.5, 1 and 5 mg/kg/day) of digoxin than their counterparts in control groups and this pattern was also observed in pathology assessment.CONCLUSION: It seems that digoxin plays an important role in iron transport into heart in iron overload state but exact mechanism of this phenomenon is not clear. L-type Ca2+ channels are good candidates that probably could be involved in iron accumulation in cardiomyocytes. Thus it would be better to reconsider digoxin administration in thalassemia and iron overload conditions.

Background: Multiple sclerosis (MS) is a chronic autoimmune inflammatory condition results in dysfunction of the central nervous system. There are multiple causes linked to the development of MS disease including EBV exposure, vitamin D deficiency, and iron overload. This study aims to examine the frequency of iron overload in all multiple sclerotic patients with reported iron serum levels at the National Guard Hospital (NGHA), Riyadh Center between 2015 and 2021.Materials and methods: A chart review based cross sectional retrospective study was conducted using the Best Care System Database, developed by NGHA, to estimate the prevalence of iron overload in MS patients. Data were analyzed to identify the correlation between serum iron and ferritin levels with disease severity and activity, which were clinically assessed by the EDSS. The mean findings of blood analysis were also compared between males and females.Results: The findings of this study showed that there was no significant relationship between disease severity and elevated serum iron and ferritin level, with p-values of 0.130 and 0.856, respectively, 54.1% of the sample had an iron level that was low/very low. The disability score of 20.3% of the sample affects their full daily activities. There was no significant difference between males and females in all means of blood analysis categories as P>0.05.Conclusion: Our study showed that the degree of disease severity and activity did not significantly correlate with the higher serum iron levels (p-value of 0.130). Further study is needed to investigate the iron level in the active MS plaques of the brain and spinal cord, and assess the severity in accordance to the sites of the specific plaques.