Falsely decreased ferritin concentrations in two patients with haemophagocytic lymphohistiocytosis: A case report. (January 2019)

• Record Type: Journal Article
• Authors: Roozen, Geert; Revet, Ingrid; Raymakers, Reinier; Kemperman, Hans
• Is Part Of: Annals of clinical biochemistry. Volume 56:Number 1(2019:Jan.)
• Page Start: 179
• Page End: 182
• Publication Date: 2019-01
• Subjects: High-dose hook -- prozone -- ferritin -- haemophagocytic lymphohistiocytosis; Clinical chemistry -- Periodicals; Clinical biochemistry -- Periodicals; 616.075
• DOI: 10.1177/0004563218793166
• Languages: English
• ISSNs: 0004-5632

Abstract

The high-dose hook effect, or prozone effect, can lead to negative or falsely lowered plasma ferritin results. Here, cases of a 16-year-old boy and a 70-year-old woman with haemophagocytic lymphohystiocytosis with extremely high concentrations of plasma ferritin (387, 000 μ g/L and 138, 000 μ g/L, respectively) are presented. In both cases, falsely lowered ferritin results were reported without any analyser flag. This article emphasizes the importance of recognition of the high-dose hook effect, since a watertight solution is lacking.