Serum ferritin and liver inflammation: which come first? Chicken or egg?

Inflammation is not the cause of an elevated serum ferritin in non-alcoholic fatty liver disease Beaton MD, et al. For the clinician the serum elevation of ferritin in chronic liver diseases (CLD), with the exception of Emochromatosis, is always as-sumed to be a non-specific marker of hepatic inflam-mation and not of iron overload.1 Nonalcoholic fatty liver disease (NAFLD) is now the most common cause of CLD.2 The spectrum of NAFLD is ranging from simple steatosis through nonalcoholic steato-hepatitis (NASH).3 Iron is regarded as a putative element that interacts with oxygen radicals, and high rates of hyperferritinemia together with increa-sed hepatic iron stores have been demonstrated in NASH.4 The role of hepatic iron in the progressio