title: Marked hyperferritinemia does not predict for HLH in the adult population.
abstract: Hemophagocytic lymphohistiocytosis (HLH) is a rare syndrome of uncontrolled immune activation that has gained increasing attention during the last decade. The diagnosis of HLH is based on a constellation of clinical and laboratory abnormalities, including elevated serum ferritin levels. In the pediatric population, marked hyperferritinemia is specific for HLH. To determine what conditions are associated with profoundly elevated ferritin in the adult population, we performed a retrospective analysis in a large academic health care system. We identified 113 patients with serum ferritin levels higher than 50,000 µg/L. The most frequently observed conditions included renal failure, hepatocellular injury, infections, and hematologic malignancies. Our results suggest that marked hyperferritinemia can be seen in a variety of conditions and is not specific for HLH in adults.
authors.affiliation: Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;
authors.forename: Alison M
authors.initials: AM
authors.lastname: Schram
authors.affiliation: Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA; and.
authors.forename: Federico
authors.initials: F
authors.lastname: Campigotto
authors.affiliation: Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;
authors.forename: Ann
authors.initials: A
authors.lastname: Mullally
authors.affiliation: Division of Hematology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA; and.
authors.forename: Annemarie
authors.initials: A
authors.lastname: Fogerty
authors.affiliation: Division of Rheumatology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
authors.forename: Elena
authors.initials: E
authors.lastname: Massarotti
authors.affiliation: Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA; and.
authors.forename: Donna
authors.initials: D
authors.lastname: Neuberg
authors.affiliation: Division of Hematology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA;
authors.forename: Nancy
authors.identifier: http://orcid.org/0000-0001-7502-6895
authors.initials: N
authors.lastname: Berliner
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005293:Ferritins / Q000097:blood*; D019337:Hematologic Neoplasms / Q000097:blood; D006801:Humans; D007239:Infections / Q000097:blood; D007249:Inflammation / Q000097:blood; D019190:Iron Overload / Q000097:blood; D008099:Liver / Q000293:injuries; D051359:Lymphohistiocytosis, Hemophagocytic / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000097:blood; D012189:Retrospective Studies; D012216:Rheumatic Diseases / Q000097:blood; D013577:Syndrome; D055815:Young Adult
chemical_list: D005293:Ferritins