Cutoff Values for Serum Ferritin in Predicting Cirrhosis Severity due to Cholestatic Jaundice in Vietnamese Children

BACKGROUND: High serum ferritin levels are associated with liver cirrhosis severity and worse outcomes for hepatopathies. This study determined the serum ferritin cutoff values for predicting cirrhosis severity in children with cholestatic jaundice. METHODS: A retrospective study was performed, including all cases diagnosed with cirrhosis in children aged 1 month to 16 years at Children’s Hospital 2-Vietnam between 2016 and 2021. Receiver operating characteristic (ROC) curve analysis was used to estimate ferritin cutoff values for predicting disease severity. RESULTS: The study included 95 patients with cirrhosis due to cholestatic jaundice. Decompensated cirrhosis accounted for the majority (74.7%) of cases. Increased serum ferritin concentrations predicted cirrhosis severity in children, and the optimal ferritin cutoff value for predicting decompensated cirrhosis was determined to be 195 μg/l, resulting in a sensitivity of 65.22%, a specificity of 95.83%, and an area under the ROC curve (AUC) or 0.82. The Child–Pugh C group had higher ferritin levels than the Child–Pugh A and B group (p < 0.001), and the ferritin cutoff value for distinguishing between Child–Pugh classifications was 195 μg/l, resulting in a sensitivity of 71.2%, a specificity of 87.9%, and an AUC of 0.80. CONCLUSIONS: Serum ferritin levels are significantly associated with decompensated cirrhosis and disease severity (as assessed by Child–Pugh score). Routine serum ferritin testing may contribute to predicting cirrhosis severity in children.