Double red blood cell donors with increased ferritin levels: a descriptive study

BACKGROUND One of the measures proposed to mitigate iron loss in blood donors is monitoring of their ferritin levels. Occasionally, high ferritin levels are found in monitored donors. We report the results of the clinical and laboratory investigation of 80 double red blood cell (DRBC) donors with high ferritin levels. STUDY DESIGN AND METHODS All DRBC donors’ ferritin levels were measured during each visit for a donation. Donors with high ferritin levels who agreed to participate underwent a clinical and laboratory evaluation. RESULTS A total of 165 of 2757 DRBC donors had at least one high ferritin level. Five were already known to suffer from hemochromatosis. A full investigation was available for 80 other donors. A total of 61 of 80 donors had normalized their ferritin level at the time of their laboratory evaluation. Only 16 donors had high serum iron levels, of whom four had increased saturation index. Genetic analysis gave the following results: C282Y homozygous, two; H63D homozygous, six; C282Y/HC3D double heterozygote, six; C282Y heterozygote, six; H63D heterozygote, 19; and no mutations, 39. None of the other laboratory investigations contributed data explaining the high ferritin levels observed. CONCLUSION In most donors with high ferritin levels, the phenomenon was transient, with normal ferritin levels found in follow-up. Less than 10% of these donors had evidence of iron overload. Only eight were homozygous for mutations associated with hemochromatosis. An extensive laboratory investigation by the treating physician should only be recommended in donors with persistently high ferritin levels.