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Increased Body Temperature01:25

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A body temperature above  38°C  (100.4 °F) is known as fever or pyrexia, and a person with fever is termed 'febrile.' Typically, the hypothalamus, a part of the brain that acts as the body's thermostat, regulates body temperature through a thermoregulatory setpoint. It receives signals from cold and warm thermal receptors throughout the body and adjusts the body's temperature accordingly. Fever occurs when this hypothalamic setpoint is altered, usually in...
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Related Experiment Video

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Extreme Hyperferritinemia: Causes and Prognosis.

Maxime Fauter1,2, Sabine Mainbourg3,4,5, Thomas El Jammal1

  • 1Department of Internal Medicine, University Hospital Croix-Rousse, Lyon 1 University, 69004 Lyon, France.

Journal of Clinical Medicine
|September 23, 2022
PubMed
Summary

Extreme hyperferritinemia, often linked to infections and hemophagocytic lymphohistiocytosis (HLH), indicates a poor prognosis. High ferritin levels significantly correlate with intensive care unit admission and mortality.

Keywords:
ferritinhemophagocytic lymphohistiocytosishyperferritinemiahyperferritinemic syndromeseptic shock

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Area of Science:

  • Clinical Medicine
  • Biochemistry
  • Hematology

Background:

  • Extreme hyperferritinemia's clinical significance and prognostic implications are not well-defined.
  • Total serum ferritin (TSF) levels ≥ 5000 µg/L warrant further investigation into underlying causes and outcomes.

Purpose of the Study:

  • To characterize the diagnoses and prognoses associated with extreme hyperferritinemia.
  • To identify the primary etiological groups contributing to elevated TSF levels.

Main Methods:

  • Retrospective analysis of adult patients with TSF ≥ 5000 µg/L across three university hospitals.
  • Classification of patients into etiological groups and recording of ICU transfer and mortality rates.

Main Results:

  • Infections (38%), hemophagocytic lymphohistiocytosis (HLH, 18%), and acute hepatitis (14%) were the most common causes.
  • Extreme hyperferritinemia (> 25,000 µg/L) was linked to HLH, infections, acute hepatitis, and cytokine release syndromes.
  • ICU transfer (32%) and mortality (28%) rates were statistically associated with ferritin levels; a TSF threshold of 13,405 μg/L predicted HLH.

Conclusions:

  • Hyperferritinemia encompasses diverse conditions, but extreme levels are primarily associated with HLH, infections, and acute hepatitis.
  • Extreme hyperferritinemia portends a poor prognosis, with significantly increased mortality.
  • Specific ferritin thresholds can aid in diagnosing conditions like HLH.