{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T05:09:36Z","timestamp":1774328976709,"version":"3.50.1"},"reference-count":69,"publisher":"SAGE Publications","issue":"13","license":[{"start":{"date-parts":[[2013,9,13]],"date-time":"2013-09-13T00:00:00Z","timestamp":1379030400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Lupus"],"published-print":{"date-parts":[[2013,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p> Ferritin is an iron storage protein considered also as an acute phase reactant with high levels in various inflammatory conditions. Recently, a plausible role for ferritin in the pathogenesis of immune-mediated and especially autoimmune diseases has been suggested. However, the link between ferritin and the antiphospholipid syndrome (APS) has been rarely explored. Therefore, in the current study we evaluated ferritin levels and their correlation to clinical and serological manifestations in patients with APS. We further analyzed ferritin levels among patients with the catastrophic variant of APS (cAPS). <\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p> Ferritin levels were determined in serum samples of 176 APS patients and 98 matched healthy controls according to age and sex (LIAISON, DiaSorin, Italy). APS samples were further analyzed for antiphospholipid (anti-cardiolipin, anti- beta-2-glycoprotein, lupus anticoagulant) and anti-infectious antibodies (CMV, EBV, rubella, toxoplasma, HBV) (LIAISON, DiaSorin, Italy). Clinical, serological and demographic manifestations were recorded. An additional analysis of ferritin levels among 14 patients with cAPS was performed. <\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p> Hyperferritinemia was present in 9% vs. 0% of APS patients and controls, respectively ( p\u2009&lt;\u20090.001). Among patients with APS, ferritin levels correlated with venous thrombosis, cardiac, neurological, and hematological manifestations and the presence of anti-CMV-IgM antibodies. Hyperferritinemia was present in 71% of cAPS patients, and ferritin levels among this subgroup were significantly higher compared with APS-non-cAPS patients (816\u2009\u00b1\u2009847\u2009ng\/ml vs. 120\u2009\u00b1\u2009230\u2009ng\/ml, p\u2009&lt;\u20090.001). <\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p> Herein, we found that hyperferritinemia correlates with the presence of APS, its clinical manifestations and specifically with the catastrophic variant of this disease. Hyperferritinemia was also linked with anti-CMV antibodies among patients with APS. These associations allude to a pathogenic role of ferritin in the pathogenesis of APS, and the plausible role of ferritin as a marker of ensuing cAPS, although further studies are needed to elucidate these associations. <\/jats:p><\/jats:sec>","DOI":"10.1177\/0961203313504633","type":"journal-article","created":{"date-parts":[[2013,9,14]],"date-time":"2013-09-14T02:31:02Z","timestamp":1379125862000},"page":"1327-1335","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":55,"title":["Ferritin in the antiphospholipid syndrome and its catastrophic variant (cAPS)"],"prefix":"10.1177","volume":"22","author":[{"given":"N","family":"Agmon-Levin","sequence":"first","affiliation":[{"name":"The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel"}]},{"given":"C","family":"Ros\u00e1rio","sequence":"additional","affiliation":[{"name":"The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel"},{"name":"Internal Medicine Department, Hospital de Pedro Hispano, Matosinhos, Portugal"}]},{"given":"B-S Porat","family":"Katz","sequence":"additional","affiliation":[{"name":"Faculty of Agricultural, Food and Environmental Quality Sciences The Hebrew University, Rehovot, Israel"}]},{"given":"G","family":"Zandman-Goddard","sequence":"additional","affiliation":[{"name":"Department of Medicine C, Wolfson Medical Center, Sackler Faculty of Medicine, Tel-Aviv University, Israel"}]},{"given":"P","family":"Meroni","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, Istituto Auxologico Italiano, University of Milan, Milan, Italy"}]},{"given":"R","family":"Cervera","sequence":"additional","affiliation":[{"name":"Department of Autoimmune Diseases, Hospital Cl\u00ednic Barcelona, Catalonia, Spain"}]},{"given":"L","family":"Stojanovich","sequence":"additional","affiliation":[{"name":"\u201cBezhanijska Kosa\u201d University Medical Center, Belgrade, Serbia"}]},{"given":"M","family":"Blank","sequence":"additional","affiliation":[{"name":"The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel"}]},{"given":"SS","family":"Pierangeli","sequence":"additional","affiliation":[{"name":"Antiphospholipid Standardization Laboratory, Division of Rheumatology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, USA"}]},{"given":"S","family":"Praprotnik","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, University Clinical Center Ljubljana, Ljubljana, Slovenia"}]},{"given":"E de","family":"Meis","sequence":"additional","affiliation":[{"name":"Clinical Pathology, Instituto Nacional do C\u00e2ncer, Rio de Janeiro, Brazil"}]},{"given":"L Parente","family":"Seguro","sequence":"additional","affiliation":[{"name":"Rheumatology Division, Faculdade de Medicina da Universidade de Sao Paulo, Brazil"}]},{"given":"A","family":"Ruffatti","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Rheumatology, University of Padova, Italy"}]},{"given":"V","family":"Pengo","sequence":"additional","affiliation":[{"name":"Department of Cardiac Thoracic and Vascular Sciences, University of Padova School of Medicine, Padova, Italy"}]},{"given":"A","family":"Tincani","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Department of Clinical and Experimental Science, Spedali Civili and University of Brescia, Italy"}]},{"given":"A","family":"Doria","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Padova, Padova, Italy"}]},{"given":"Y","family":"Shoenfeld","sequence":"additional","affiliation":[{"name":"The Zabludowicz Center for Autoimmune 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