SP03 | LACTOFERRIN AND ANEMIA OF INFLAMMATION: A CASE REPORT

Background Iron plays a vital role in cellular functions but becomes toxic when present in excess, contributing to oxidative damage. Ferritin (Ftn), a protein capable of sequestering up to 4,500 atoms of iron per molecule, is crucial for iron regulation and functions as an acute-phase reactant. Elevated serum Ftn levels reflect an inflammatory state that can be observed in various diseases. Case presentation The case described concerns a 81-year-old male who developed severe anemia following a femoral neck fracture and surgery (hemoglobin = 7.8 g/dL). Therefore, he received two blood transfusions and began therapy with oral iron salts. Hemoglobin (Hb) levels initially increased to 10.8 g/dL but showed a marked decline four days later (Hb = 6.8 g/dL). The patient once again received two additional blood transfusions and an intravenous dose of iron (Ferlixit). After an initial rise, Hb levels one more time decreased (from 10.1 to 8.5 g/dL). Since the patient had elevated levels of C-reactive protein (CRP) (79 mg/L), erythrocyte sedimentation rate (ESR) (125 mm/h), and Ftn (650 mcg/L), iron therapy and transfusions were stopped. Treatment with lactoferrin (Lf) (capsules Mosiac Plus, Pharmaguida-Italy, containing 200 mg of Lf) was initiated at a dose of three capsules per day, taken before meals, divided in two daily administrations. Results Within a few days, notable improvements were observed, including an increased number of red blood cells and Hb levels, along with a reduction in CRP, ESR, and Ftn levels. These positive trends persisted over time, allowing for a gradual reduction in the Lf dose to two capsules per day, and subsequently to one capsule per day. Conclusions Lactoferrin effectively resolved anemia of inflammation, reduced inflammatory markers (CRP, ESR, and Ftn), and avoided the need for further transfusions or iron salts therapy. This case highlights lactoferrin's potential in managing inflammation-related anemia.