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Determination of an appropriate cut‐off value for ferritin in the diagnosis of hemophagocytic lymphohistiocytosis
Author(s) -
Lehmberg Kai,
McClain Kenneth L.,
Janka Gritta E.,
Allen Carl E.
Publication year - 2014
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25058
Subject(s) - hemophagocytic lymphohistiocytosis , medicine , ferritin , serum ferritin , receiver operating characteristic , value (mathematics) , gastroenterology , immunology , pediatrics , disease , statistics , mathematics
Hyperferritinemia is a hallmark of hemophagocytic lymphohistiocytosis (HLH). In the HLH‐2004 criteria, a ferritin value >500 µg/L is considered positive. However, this level was not determined based on evidence. We compared 123 patients with HLH and 320 patients with other hyperferritinemic conditions, calculated a receiver‐operating characteristic, and determined sensitivity and specificity for different values. At 2,000 µg/L a trade‐off is reached with sensitivity at 70% and specificity at 68%. If familial HLH and virus‐associated acquired HLH are analyzed separately, sensitivity and specificity are similar for this level. The results may guide a potential modification of the current HLH criteria. Pediatr Blood Cancer 2014;61:2101–2103. © 2014 Wiley Periodicals, Inc.