Format

Send to

Choose Destination
Ann Hematol. 2017 Oct;96(10):1667-1672. doi: 10.1007/s00277-017-3072-0. Epub 2017 Jul 31.

Elevated serum ferritin is not specific for hemophagocytic lymphohistiocytosis.

Author information

1
Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8118, St. Louis, MO, 63110, USA. zaherotrock@hotmail.com.
2
Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave, Campus Box 8118, St. Louis, MO, 63110, USA.
3
Forensic Toxicology Laboratory, Saint Louis University, St Louis, MO, USA.
4
Radboud University Medical Center, Nijmegen, The Netherlands.

Abstract

Hemophagocytic lymphohistiocytosis (HLH) is a rare, potentially fatal, syndrome of excessive and ineffective activation of the immune system. The majority of the reported data on HLH is from pediatric patients and lacks specificity. This makes HLH diagnosis challenging especially in adults where HLH is triggered by many conditions and can resemble many disease entities. Elevated ferritin is one of the diagnostic criteria for HLH. We determined the conditions associated with elevated ferritin at our medical center to assess how specific ferritin is for predicting HLH. We retrospectively reviewed all ferritin results >10,000 μg/L in pediatric and adult patients. The most common condition associated with elevated ferritin was hematologic malignancy in adults (25.7%) and HLH in pediatric patients (48.9%). HLH was diagnosed in 14.2% of adults and 48.9% of children with ferritin >10,000 µg/L. Hyperferritinemia occurs in a variety of conditions and is not specific for adult or pediatric HLH. Common causes of elevated ferritin should be considered before entertaining the possibility of HLH, especially in adult patients.

KEYWORDS:

Adults; Diagnosis; Ferritin; Hemophagocytic lymphohistiocytosis; Pediatrics; Specific

PMID:
28762079
DOI:
10.1007/s00277-017-3072-0
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center