Ferritin
Acute-phase reactant and hallmark biomarker; synthesis driven by multiple cytokines
- Expression
- Markedly elevated
- Evidence level
- established
Role in pathogenesis
Hyperferritinemia is a hallmark of AOSD, with levels often exceeding 1,000 ng/mL. Ferritin synthesis is upregulated at transcriptional and translational levels by IL-1β, IL-6, IL-18, TNF-α, IFN-γ, and M-CSF. The low glycosylated fraction (<20%) reflects saturated glycosylation during massive hepatic production. Ferritin serves as a diagnostic marker, disease activity indicator, and predictor of MAS and poor prognosis.