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Hyperferritinemic Sepsis: An Opportunity for Earlier Diagnosis and Intervention?

We describe a case of an infant with HSV meningitis and septic shock who demonstrated a remarkably high serum ferritin level. Aggressive pediatric intensive care and the administration of high-dose glucocorticoids were not able to reverse the multiple organ dysfunctions. Subsequent autopsy identifie...

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Detalles Bibliográficos
Autores principales: Halstead, E. Scott, Rajasekaran, Surender, Fitzgerald, Julie C., Weiss, Scott L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4969285/
https://www.ncbi.nlm.nih.gov/pubmed/27532033
http://dx.doi.org/10.3389/fped.2016.00077
Descripción
Sumario:We describe a case of an infant with HSV meningitis and septic shock who demonstrated a remarkably high serum ferritin level. Aggressive pediatric intensive care and the administration of high-dose glucocorticoids were not able to reverse the multiple organ dysfunctions. Subsequent autopsy identified the presence of hemophagocytosis, thus the patient fulfilled hemophagocytic lymphohistiocytosis (HLH) criteria post-mortem. This case highlights that serum ferritin may be an important early indicator of mortality in sepsis due to a cytokine storm similar to macrophage activation syndrome and HLH.