Clinical and procedural experience using transjugylar intrahepatic portosystemic shunt (TIPS) on 7 children with recurrent hemorrhage of esophageal varices is reported. Recurrent hemorrhage from esophageal varices following repeated paravasal sclerosing of the varices as well as severe-grade hypersplenism are proposed as the indication for its use. The technical details of TIPS, observed and possible early and late complications, the demand for a decrease in the portosystemic pressure gradient to less than 15 mmHg and the influence of TIPS on improvement of the varices, hypersplenism and the frequently observed malabsorption are described.

HScore reflects a higher specificity than the algorithm for diagnosing HLH. The discrepancy may indicate the difficulty that a specific marker still is missing. Hyperferritinaemia was strongly associated with HLH in patients with haematological or oncological malignancies. HLH may be underdiagnosed because the majority of these patients suffer from a severe underlying disease, which easily might suggest a flare or infection. In this population, hyperferritinaemia and SIRS should rise suspicion because mortality in HLH is high.