Ferritin Levels in Patients with Pemphigus at a Hospital in Campo Grande, Brazil

Abstract

Introduction. Pemphigus is a chronic autoimmune disease characterized by blistering lesions on the skin and mucous membranes. Ferritin, in addition to its role in iron metabolism, acts as an acute-phase reactant useful in inflammatory processes. This study evaluated the relationship between serum ferritin levels and the clinical activity/severity of pemphigus.
Methods. A retrospective and descriptive study was conducted with a sample of 88 patients diagnosed with pemphigus foliaceus or pemphigus vulgaris, treated at a reference hospital in Mato Grosso do Sul, Brazil (August
2019-April 2025). Serum ferritin level variables and disease severity were analyzed using validated scoring systems: the Pemphigus Vulgaris Activity Index (PVAS) and the Pemphigus Disease Area Index (PDAI).
Results. Pemphigus foliaceus was more frequent (72.73%). No global statistical association was found between clinical severity and ferritin levels (p>0.05). Men generally presented higher ferritin levels. A non-linear trend was observed: an increase in ferritin in mild to moderate cases, a decrease in severe cases, and late elevation patterns in 25 patients.
Conclusions. The study demonstrated that serum ferritin is not statistically associated with the clinical severity
of pemphigus; therefore, it should not be used as a sole or direct biomarker of disease activity. Epidemiologically,
pemphigus foliaceus predominated, and men presented higher ferritin levels. Although it does not reflect severity
linearly—showing an increase in moderate cases but a drop in severe ones, as well as late elevations—its measurement provides complementary value for identifying specific inflammatory profiles. Larger studies are required to quantify these findings.