Affiliations: Department of Pediatrics, University of Nebraska
Medical Center, Omaha, NE, USA | Department of Emergency Medicine, Children's Hospital
and Medical Center, Omaha, NE, USA | Department of Pathology, Children's Hospital and
Medical Center, Omaha, NE, USA | Department of Statistics, College of Public Health,
University of Nebraska Medical Center, Omaha, NE, USA
Note: [] Corresponding author: Arwa Nasir, Department of Pediatrics,
University of Nebraska Medical Center, 982167 Nebraska Medical Center, Omaha,
NE 68198-2167, USA. Tel.: +1 402 559-3131; Fax: +1 402 559 5137; E-mail: anasir@unmc.edu
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
