Ferritin levels in children with severe sepsis and septic shock

García, Pedro Celiny Ramos; Longhi, F; Branco, Ricardo Garcia; Piva, Jefferson Pedro; Lacks, Dani; Tasker, Robert C.

doi:10.1111/j.1651-2227.2007.00564.x

Cited by 110 publications

(78 citation statements)

References 14 publications

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“…This is in line with data from septic patients who showed an increase in ferritin levels. 22 The increase in ferritin in the DA group was interpreted due to increased intestinal iron absorption, which would be in line with data after EPO treatment in rats 23 and humans. 24 Of interest, the observation of suppression of DAs effects after administration of LPS in our experiments contrasts with the effects of DA or EPO in inflammatory diseases other than sepsis, which respond to exogenously administered EPO.…”

Section: Discussionsupporting

confidence: 62%

Lipopolysaccharide Evokes Resistance to Erythropoiesis Induced by the Long-Acting Erythropoietin Analogue Darbepoetin Alfa in Rats

Brendt¹,

Horwat²,

Schäfer³

et al. 2009

Anesthesia &Amp; Analgesia

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Section: Discussionsupporting

confidence: 62%

Lipopolysaccharide Evokes Resistance to Erythropoiesis Induced by the Long-Acting Erythropoietin Analogue Darbepoetin Alfa in Rats

Brendt¹,

Horwat²,

Schäfer³

et al. 2009

Anesthesia &Amp; Analgesia

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“…Similar results were shown in another study of 94 children in PICU [45]. Serum ferritin levels were associated with outcome in patients with severe sepsis or septic shock, and a ferritin level of [500 ng/mL was associated with a 3.2 (1.3-7.9) relative risk of death (p = 0.01) [46]. In many areas of the world there is limited laboratory support, and clinicians have little choice but to focus on known epidemiology and treat empirically based on most likely pathogens [47].…”

Section: Diagnostic Testssupporting

confidence: 73%

What’s New in the Recognition and Management of Septic Shock in Children: Dos and Don'ts

Argent

2013

Curr Pediatr Rep

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While there has been a reduction in the number of children dying of septic shock in the richer countries of the world, septic shock remains an important cause of both mortality and morbidity for children across the world. Major reduction in the incidence of septic shock will depend on the implementation of public health measures, including immunization. Improvements in outcome of pediatric septic shock have been closely linked to early recognition (although this may be challenging in many situations); early antibiotic administration; early and appropriate fluid administration and subsequent escalation of critical care. A particular challenge has been the development and implementation of systems to ensure that these elements of management are reliably and efficiently implemented in children (even in well-resourced countries). Recent studies have highlighted the complexity of caring for patients with acute severe sepsis and septic shock in countries with fewer resources, and there is an urgent need for further studies to elucidate the implications of these studies for the management of children with septic shock, particularly in settings where additional critical care support such as inotropic or ventilator support may not be readily available.

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“…Dans le CAPS, l'hyperferritinémie est plus élevée que chez les patients porteurs d'anticorps anti-phospholipides sans complication (816 ± 847 contre 120 ± 230 g/L) [69]. Dans le choc septique chez l'enfant, une hyperferritinémie supérieure à 500 g/L était associée à un risque relatif de décès multiplié par 3,2 (1,3-7,9) [70]. Pour les auteurs, ces quatre pathologies ont des signes cliniques et biologiques communs et certaines thérapeutiques identiques (corticoïdes, immunoglobulines intraveineuses, échanges plasmatiques).…”

Section: Le Risque De Surcharge Est-il En Relation Avec L'importance unclassified

“…Pour cette raison, si la recherche étiologique reste hésitante, si plusieurs causes sont associées, si le taux de ferritinémie a tendance à augmenter dans le temps, il devient indispensable de proposer une étude IRM du foie avec évaluation de la charge en fer. Il est possible d'évaluer cette concentration en fer au niveau hépatique par un examen IRM lorsque les valeurs sont comprises entre 60 et 370 mol/g (N < 36 mol/g) [70]. Cette méthode, non traumatique, a permis de diminuer très fortement les indications de la biopsie hépatique dans le bilan d'une hyperferritinémie non élucidée [71].…”

Section: Le Risque De Surcharge Est-il En Relation Avec L'importance unclassified

Démarche diagnostique devant une hyperferritinémie

Lorcerie¹,

Audia²,

Samson³

et al. 2015

La Revue de Médecine Interne

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The discovery of a hyperferritinemia is most of the time fortuitous. The diagnostic approach aims at looking for the responsible etiology and at verifying if an iron hepatic overload is present or not. Three diagnostic steps are proposed. The clinical elements and a few straightforward biological tests are sufficient at first to identify one of the four main causes: alcoholism, inflammatory syndrome, cytolysis, and metabolic syndrome. None of these causes is associated with a significant iron hepatic overload. If the transferring saturation coefficient is raised (>50%) a hereditary hemochromatosis should be discussed. Secondly, less common disorders will be discussed. Among these, only the chronic hematological disorders either acquired or congenital are at risk of iron hepatic overload. Thirdly, if a doubt persists in the etiologic research, and the serum ferritin level is very high or continues to rise, it is essential to verify that there is no iron hepatic overload. For that purpose, the MRI with study of the iron overload is the main test, which will guide the therapeutic attitude. Identification of more than a single etiology occurs in more than 40% of the cases.

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Ferritin levels in children with severe sepsis and septic shock

Abstract: Ferritin is raised in children with septic shock and high ferritin level is associated with poorer outcome.

Cited by 110 publications

References 14 publications

Lipopolysaccharide Evokes Resistance to Erythropoiesis Induced by the Long-Acting Erythropoietin Analogue Darbepoetin Alfa in Rats

Lipopolysaccharide Evokes Resistance to Erythropoiesis Induced by the Long-Acting Erythropoietin Analogue Darbepoetin Alfa in Rats

What’s New in the Recognition and Management of Septic Shock in Children: Dos and Don'ts

Démarche diagnostique devant une hyperferritinémie

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