ArticleJournal of clinical medicine2022
Differential Diagnosis of Hyperferritinemia in Critically Ill Patients.
Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed, 15 citations in OpenAlex.
- Early Differential Diagnosis of Epstein-Barr Virus-Associated Hemophagocytic Lymphohistiocytosis and Macrophage Activation Syndrome in Children: A Clinical Prediction Model Based on 106 Patients.Pathogens (Basel, Switzerland) · 2026Article
- Predictive value of NLMR, PLR, and ferritin in relation to SOFA, APACHE II, and SAPS II in sepsis patients.Journal of critical care medicine (Universitatea de Medicina si Farmacie din Targu-Mures) · 2026Article
- Normoferritinemic Versus Hyperferritinemic Inflammation in Patients Admitted to the Department of Internal Medicine.Journal of clinical medicine · 2026Article
- Hyperinflammatory Syndrome of Unknown Origin Complicated by Shock, DIC, Intracranial Hemorrhage and Spontaneous Splenic Rupture: A Case Report.Clinical medicine insights. Case reports · 2026Article
- Hyperferritinemia and Macrophage Activation Syndrome in Septic Shock: Recent Advances with a Pediatric Focus (2020-2025).Children (Basel, Switzerland) · 2025Review
- Characteristics of 21 Patients with Secondary Hemophagocytic Lymphohistiocytosis-Insights from a Single-Center Retrospective Study.Medicina (Kaunas, Lithuania) · 2025Article
- Febrile Rash, Shock, and Hyperferritinaemia in A Young Woman: Navigating the Diagnostic Overlap of Hemophagocytic Lymphohistiocytosis, Toxic Shock, and Viral Exanthema.European journal of case reports in internal medicine · 2025Article
- Prognostic implications of serum ferritin levels in non-anemic women with stage 3 chronic kidney disease.Frontiers in nutrition · 2025Article
- Article
- Unleashing the Cytokine Storm: A Case of Macrophage Activation Syndrome in Systemic Lupus Erythematosus.Cureus · 2024Article
- Cytokine Storm and Sepsis-Induced Multiple Organ Dysfunction Syndrome.Advances in experimental medicine and biology · 2024Review
- Inpatient recognition and management of HLH.Hematology. American Society of Hematology. Education Program · 2023Review
- Atypical Adult Still's Disease Complicated by Hemophagocytic Syndrome in an Older Patient: A Case Report.Cureus · 2023Article
- Hyperferritinemia is Associated with Thrombocytopenia and Increased Mortality Risk in Adult Sepsis Patients: A Retrospective Study of Two Observational Cohorts.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisObservational
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundElevated serum ferritin is a common condition in critically ill patients. It is well known that hyperferritinemia constitutes a good biomarker for hemophagocytic lymphohistiocytosis (HLH) in critically ill patients. However, further differential diagnoses of hyperferritinemia in adult critically ill patients remain poorly investigated. We sought to systematically investigate hyperferritinemia in adult critically ill patients without HLH.
methodsIn this secondary analysis of a retrospective observational study, patients ≥18 years admitted to at least one adult intensive care unit at Charité-Universitätsmedizin Berlin between January 2006 and August 2018, and with hyperferritinemia of ≥500 μg/L were included. Patients with HLH were excluded. All patients were categorized into non-sepsis, sepsis, and septic shock. They were also classified into 17 disease groups, based on their ICD-10 codes, and pre-existing immunosuppression was determined. Uni- and multivariable linear regression analyses were performed in all patients.
resultsA total of 2583 patients were analyzed. Multivariable linear regression analysis revealed positive associations of maximum SOFA score, sepsis or septic shock, liver disease (except hepatitis), and hematological malignancy with maximum ferritin. T/NK cell lymphoma, acute myeloblastic leukemia, Kaposi's sarcoma, acute or subacute liver failure, and hepatic veno-occlusive disease were positively associated with maximum ferritin in post-hoc multivariable linear regression analysis.
conclusionsSepsis or septic shock, liver disease (except hepatitis) and hematological malignancy are important differential diagnoses in hyperferritinemic adult critically ill patients without HLH. Together with HLH, they complete the quartet of important differential diagnoses of hyperferritinemia in adult critically ill patients. As these conditions are also related to HLH, it is important to apply HLH-2004 criteria for exclusion of HLH in hyperferritinemic patients. Hyperferritinemic critically ill patients without HLH require quick investigation of differential diagnoses.
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