HomeAnswersMedical GastroenterologyhemochromatosisDo I have ferroportin disease if my ferritin level and transferrin saturation are high?

What do high ferritin and transferrin saturation with mutation of SLC40A1 gene marker mean?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Ajeet Kumar

Medically reviewed by

iCliniq medical review team

Published At September 23, 2021
Reviewed AtAugust 31, 2023

Patient's Query

Hello doctor,

I am a 29-year-old male, and I fear that I might have ferroportin disease.

I persistently have high ferritin levels, and my transferrin saturation is also mildly above the normal range. I have also looked at my genotyping on chromosome 2 and noticed a single nucleotide mutation for my SLC40A1 gene marker.

I have not had a liver biopsy. I do have a mild hepatic steatosis evident in my abdominal ultrasound. The gastroenterologist believes that this may be NAFLD; however, I previously drank alcohol to excess but was abstinent for two years before the ultrasound.

Kindly help.

Answered by Dr. Ajeet Kumar

Hello,

Welcome to icliniq.com.

Having H63D (histidine at amino acid position 63) carrier does not indicate a diagnosis of hemochromatosis. Similarly, you have one of the gene alleles for ferroportin disease. However, the transferrin saturation should be low in ferroportin disease. On the other hand, the same gene is also associated with hemochromatosis, the excessive accumulation of iron in the liver and other tissues like bones, heart, and pancreas. I would like to see your liver function test and serum ferritin level and transferrin saturation since a transferrin saturation of more than 55% and ferritin of more than 500 mcg/L on a background of the characteristic genetic mutation for hemochromatosis would diagnose the disease irrespective of liver biopsy.

It will help if you share your reports of the liver function tests and abdomen ultrasound. Please do share the current iron profile as well.

Thanks.

Patient's Query

Hello doctor,

Thanks for the reply.

Please find the attached results. I have not done an ultrasound abdomen. I am working as a paramedic, and I smoke cigarettes daily, and I was alcoholic during university years. Previously took cannabis and few lines of cocaine.

At present, my weight is 119 lbs. I am experiencing an unintentional weight loss without and awaiting for my colorectal review.

Kindly help.

Answered by Dr. Ajeet Kumar

Hello,

Welcome back to icliniq.com.

Thanks for providing further information in your case.

Your liver function tests are normal. The raised alanine transferase may be because of alcohol or due to some drug side effects. Neither your fibroscan nor your weight suggests that you have NAFLD (non-alcoholic fatty liver disease) as the diagnosis of NAFLD is established in overweight individuals, with the presence of fat in the liver and disturbed liver function tests.

I suggest you check hepatitis B and hepatitis C profiles and stool antigens to check H.pylori infection before starting the course of antibiotics.

I hope this answers your concerns.

Regards.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Ajeet Kumar
Dr. Ajeet Kumar

Medical Gastroenterology

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