Extremely High Ferritinemia Associated with Haemophagocytic Lympho Histiocytosis (HLH)

Hyperferritinemia (>10,000 ng/ml) is an important hallmark used as an indicator of infection triggered macrophage activation syndrome leading to hemophagocytic lympho histiocytosis (HLH). Measurement of serum ferritin can be used in diagnosis as well as disease monitoring indicator and prognosis related to HLH, cAPS, sepsis, neoplasm and inflammatory conditions. It is a major contributor to manage critically ill patients as predicting and monitoring indicator. It can be used as acute phase response in conditions of MAS, AOSD, cAPS etc. A case study in our hospital showed extremely high ferritin values along with low hemoglobin, elevated LDH and triglycerides with positive MRSA in sputum culture and macrophage proliferation and hemophagocytosis in the bone marrow examination. Patient showed definite inverse relation with steroid therapy and serum ferritin levels.