Low transferrin and high ferritin concentrations are associated with worse outcome in acute liver failure

Abstract

High ferritin and low transferrin levels are associated with worse outcome in patients with acute liver failure. A model incorporating age, MELD score and transferrin outperformed MELD score for 90-day overall survival of non-transplanted patients.

High ferritin levels are not only but mostly because of liver specific injury

“…ALF was associated with high ferritin levels in our study (2). In our cohort, 75 of 102 patients had ferritin levels above 500 ng/mL (Table 1).…”

“…The authors thank Dr. Brito-Azevedo for his interest in our paper and the opportunity to look at our data from a different perspective (1,2). Haemophagocytic lymphohistiocytosis (HLH) is a rare condition, associated with defective termination of the immune system, leading to multiorgan failure.…”

High ferritin concentration in acute liver failure: The top of the iceberg?

“…They concluded that high ferritin and low transferrin levels are associated with worse outcome in patients with ALF. 1 As well pointed by authors, ferritin is also associated with inflammatory conditions. However, extremely high levels may be associated with a specific inflammatory disease, the hemophagocytic lympho- It is important to keep HLH as differential diagnosis in mind.…”

Liver Fibrosis Markers Improve Prediction of Outcome in Non‐Acetaminophen‐Associated Acute Liver Failure

“…Several researchers have suggested that modifications might be needed to improve the prognostic value of the MELD system. ( )…”

“…Several researchers have suggested that modifications might be needed to improve the prognostic value of the MELD system. (11,12) Although patients with ALF may have similar clinical manifestations, the initial symptoms are usually obscure. Furthermore, the time from liver insult to the presence of ALF varies greatly.…”