AUTHOR=Halstead E. Scott , Rajasekaran Surender , Fitzgerald Julie C. , Weiss Scott L. TITLE=Hyperferritinemic Sepsis: An Opportunity for Earlier Diagnosis and Intervention? JOURNAL=Frontiers in Pediatrics VOLUME=4 YEAR=2016 URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2016.00077 DOI=10.3389/fped.2016.00077 ISSN=2296-2360 ABSTRACT=

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.