Falsely decreased ferritin concentrations in two patients with haemophagocytic lymphohistiocytosis: A case report

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Geert Roozen1, Ingrid Revet1, Reinier Raymakers2

  • 11 Department of Clinical Chemistry and Haematology, University Medical Center Utrecht, Utrecht, The Netherlands.

Annals of Clinical Biochemistry
|July 21, 2018
PubMed

The high-dose hook effect, or prozone effect, can lead to negative or falsely lowered plasma ferritin results. Here, cases of a 16-year-old boy and a 70-year-old woman with haemophagocytic lymphohystiocytosis with extremely high concentrations of plasma ferritin (387,000  μg/L and 138,000  μg/L, respectively) are presented. In both cases, falsely lowered ferritin results were reported without any analyser flag. This article emphasizes the importance of recognition of the high-dose hook effect, since a watertight solution is lacking.

Keywords:
High-dose hookferritinhaemophagocytic lymphohistiocytosisprozone

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