Low glycosylated ferritin, a good marker for the diagnosis of hemophagocytic syndrome

Abstract

Objective. A very low percentage of glycosylated ferritin (<20%) has only been reported in association with adult-onset Still's disease (AOSD), a disease classically associated with hemophagocytic syndrome. We undertook this study to determine whether hemophagocytic syndrome outside the context of AOSD is also associated with a very low percentage of glycosylated ferritin.Methods. From October 2006 to September 2007, the serum level of glycosylated ferritin was determined in all consecutive patients seen in 3 departments and for whom the diagnosis of hemophagocytic syndrome was suspected. The level of glycosylated ferritin in these patients was compared with that in age-and sexmatched controls with a marked inflammatory syndrome not associated with hemophagocytic syndrome. We assessed the value of glycosylated ferritin as a marker for the diagnosis of hemophagocytic syndrome.Results. Forty-two patients were included in the study (14 with confirmed hemophagocytic syndrome, 7 with suspected but unconfirmed hemophagocytic syndrome, and 21 controls). The median level (interquartile range Conclusion. These results suggest that glycosylated ferritin may be a helpful marker for the diagnosis of hemophagocytic syndrome.[

Marked hyperferritinemia does not predict for HLH in the adult population

“…A recent study by Fardet et al reported that the fraction of glycosylated ferritin is lower in patients with HLH compared with other inflammatory disorders. 30 Further investigation is necessary to validate this observation and identify novel markers of HLH.…”

High Serum Ferritin in Adult-Onset Still's Disease

“…Although the serum ferritin level fluctuates during systemic inflammation, GF remains low several weeks to months after disease remission [8]. However, a low level of GF is not specific to AOSD; it is observed also in other inflammatory processes like in severe systemic infections [5] or haemophagocytic syndromes [9].…”

Hemophagocytic lymphohistiocytosis secondary to infections: a tertiary care experience

“…31,33 Low glycosylated Ferritin was found to be useful in assisting the diagnosis in patients with ferritin values between 500 and 10,000 µg/L. 34,35 Bone Marrow (BM) score is based upon number of hemophagocytic cells per high power field, and classified as mild (1-2), moderate (3-5), severe (6)(7)(8), very severe (˃8). 36 Bone marrow finding may be a late manifestation with false negativity if done early.…”