Case 71 – update 1

Our patient has a high ferritin. He has complained of joint pains affecting the knees and hands for some time and was diagnosed with osteoarthritis. He takes occasional paracetamol for this. He does not have a history of blood transfusion. He does drink more than the recommended allowance – 30 units of alcohol per week. He does not give a history of features of hypogonadism but he has had a ‘flu-like illness which laid him in bed for a few days. He feels generally tired.

 

On examination he does not have a bronzed skin and there is no hepatomegaly.

 

LFTs show:

  • Albumin 40g/L (35-50)
  • Bilirubin 15μg/L (3-20)
  • Alkaline phosphatase 120IU/L (30-130)
  • Alanine aminotransferase 85U/L (1-50)

 

Questions (please reply with #TeamHaem in your tweet!)

  • What are the causes of a raised ferritin?
  • What further investigations would you perform at this time?

 

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