ReviewBMC medicine2013
The hyperferritinemic syndrome: macrophage activation syndrome, Still's disease, septic shock and catastrophic antiphospholipid syndrome.
Review in BMC medicine, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03841162 (Fast Assay for Pathogen Identification and Characterization - Prospective Observational Study), which is not on this map. Cited by 225 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Fast Assay for Pathogen Identification and Characterization - Prospective Observational Study
Who cites it
225 citing papers in PubMed, 5 syntheses or guidelines pooled it, 469 citations in OpenAlex.
- Pooled it
- Bibliometrics analysis on the research status and trends of adult-onset Still's disease: 1921-2021.Frontiers in immunology · 2022Pooled it
- Update in Hyperferritinemic Syndromes: Recognition and Management - A Scoping Review.The Brown journal of hospital medicine · 2022Pooled it
- Paediatric inflammatory multisystem syndrome temporally associated with COVID-19 (PIMS-TS): a narrative review and the viewpoint of the Latin American Society of Pediatric Intensive Care (SLACIP) Sepsis Committee.BMJ paediatrics open · 2021Pooled it
- COVID-19 and ischemic stroke: a systematic review and meta-summary of the literature.Journal of thrombosis and thrombolysis · 2020Pooled it
- Toward personalized immunotherapy in sepsis: The PROVIDE randomized clinical trial.Cell reports. Medicine · 2022Trial
- Ferritin is associated with the severity of lung involvement but not with worse prognosis in patients with COVID-19: data from two Italian COVID-19 units.Scientific reports · 2021Trial
- Macrophage activation-like syndrome: an immunological entity associated with rapid progression to death in sepsis.BMC medicine · 2017Trial
- Article
- Ferritin and LDH predict thrombotic risk beyond conventional scoring systems in DLBCL.Annals of hematology · 2026Article
- Relationship of Ferritin and Procalcitonin with SOFA-2 Scores in Intensive Care Patients with COVID-19-Associated Sepsis: A Cross-Sectional Analysis.Biomedicines · 2026Article
- Adjunctive Therapeutic Plasma Exchange in Refractory Adult-Onset Still's Disease Complicated by Secondary Macrophage Activation Syndrome: A Single-Center Experience.Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy · 2026Article
- Observational
- Prevalence and Diagnostic Challenge of Hemophagocytic Lymphohistiocytosis Syndrome in Critically Ill Patients.European journal of haematology · 2026Article
- Integrating serum ferritin and neutrophil-to-lymphocyte ratio with Sequential Organ Failure Assessment score improves mortality prediction in sepsis.World journal of methodology · 2026Article
- The Prevalence of Anemia and Diagnostic Usefulness of Ferritin and Hepcidin in Antiphospholipid Syndrome and Systemic Lupus Erythematosus Patients.Diseases (Basel, Switzerland) · 2026Article
- Development of a Machine Learning-Based Prediction Model to Differentiate Infectious and Non-Infectious Diseases in Patients with Undiagnosed Fever: A Single Hospital-Based Retrospective Study.Journal of clinical medicine · 2026Article
- Topographical Variation of Iron-Rimmed Lesions in the Multiple Sclerosis Brain and Spinal Cord: A Neuropathological Study.Annals of neurology · 2026Article
- Emergency in pediatric rheumatology: a narrative review.Frontiers in medicine · 2026Review
- Article
165 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOver the last few years, accumulating data have implicated a role for ferritin as a signaling molecule and direct mediator of the immune system. Hyperferritinemia is associated with a multitude of clinical conditions and with worse prognosis in critically ill patients. DISCUSSION: There are four uncommon medical conditions characterized by high levels of ferritin, namely the macrophage activation syndrome (MAS), adult onset Still's disease (AOSD), catastrophic antiphospholipid syndrome (cAPS) and septic shock, that share a similar clinical and laboratory features, and also respond to similar treatments, suggesting a common pathogenic mechanism. Ferritin is known to be a pro-inflammatory mediator inducing expression of pro-inflammatory molecules, yet it has opposing actions as a pro-inflammatory and as an immunosuppressant. We propose that the exceptionally high ferritin levels observed in these uncommon clinical conditions are not just the product of the inflammation but rather may contribute to the development of a cytokine storm. SUMMARY: Here we review and compare four clinical conditions and the role of ferritin as an immunomodulator. We would like to propose including these four conditions under a common syndrome entity termed "Hyperferritinemic Syndrome".
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.