Hyperferritinemia in the critically ill child with secondary hemophagocytic lymphohistiocytosis/sepsis/multiple organ dysfunction syndrome/macrophage activation syndrome: what is the treatment?

Demirkol, Demet; Yildizdas, Dincer; Bayrakci, Benan; Karapinar, Bulent; Kendirli, Tanil; Koroglu, Tolga F; Dursun, Oguz; Erkek, Nilgün; Gedik, Hakan; Citak, Agop; Kesici, Selman; Karabocuoglu, Metin; Carcillo, Joseph A

doi:10.1186/cc11256

Critical Care

Table 4 Demographic characteristics and laboratory variables of survivors and non-survivors

From: Hyperferritinemia in the critically ill child with secondary hemophagocytic lymphohistiocytosis/sepsis/multiple organ dysfunction syndrome/macrophage activation syndrome: what is the treatment?

	Survivors (n= 20)			Non-survivors (n= 3)
	Frequency, percentage		Number	Frequency, percentage		Number	P
Females/Males	20/80		4/16	67/33		2/1	0.08
Underlying disease	80		16	67		2	0.6
Mechanical ventilation	85		17	100		3	0.5
	Mean ± SD	Median	Range	Mean ± SD	Median	Range	P
Age, years	6.9 ± 3.3	6.7	2-14	8 ± 6.3	6.2	2.8-15.1	0.7
PRISM III-24 score	25.3 ± 13	21	7-48	14 ± 5.1	14	11-21	0.2
PELOD score	27.2 ± 14.5	25	4-53	22.3 ± 9.1	21	14-32	0.7
Number of organs involved	4.5 ± 1	5	3-6	5 ± 1	5	4-6	0.5
Hemoglobin, g/dL	7.5 ± 1.4	8	4.8-8.9	9.6 ± 4.9	8.8	5.2-15	0.4
Leukocytes,/mm³	8,814 ± 8,836	6,220	400-26,400	19,900 ± 22,981	11,000	2,700-46,000	0.3
Absolute neutrophil count,/mm³	66,688 ± 7,279	4,370	0-23,000	14,816 ± 17,783	8,030	1,450-35,000	0.3
Platelets,/mm³	59,255 ± 57,758	48,000	10,000-235,000	59,000 ± 35,510	79,000	18,000-80,000	0.6
PT, seconds	26.4 ± 14.9	24.9	10.3-69	15.3 ± 1.3	15.3	13.9-16.5	0.2
aPTT, seconds	41.9 ± 14.1	39	24.7-74	41.2 ± 17.2	39.4	25-59	0.5
Fibrinogen, mg/dL	201 ± 162	180	0-607	236 ± 180	156	110-443	0.2
Triglycerides, mg/dL	554 ± 349	436	122-1551	559.5 ± 417	638	108-931	0.7
Albumin, g/dL	2.6 ± 0.6	2.7	1.4-4.1	2.8 ± 0.5	2.6	2.4-3.3	0.8
Sodium, mEq/L	131 ± 6	132	120-141	141 ± 8.5	141	135-147	0.3
ALT, U/L	324 ± 585	128	21-2,362	5,751 ± 7,812	1250	227-11,276	0.14
LDH, U/L	3,884 ± 3146	2300	410-11,270	2,327 ± 2,665	2,327	443-4,212	0.6
Ferritin, μg/dL	20,124 ± 27163	5054	765-100,000	40,802 ± 34,583	40,802	16,348-65,256	0.06
Treatment protocols	Frequency	Number		Frequency	Number		0.002
PE and chemotherapy or dexamethasone (protocols 3 and 4)	50%	3/6		50%	3/6
PE and methylprednisolone or IVIG (protocols 1 and 2)	100%	17/17		None

ALT, alanine aminotransferase; aPTT, activated partial thromboplastin time; IVIG, intravenous immunoglobulin; LDH, lactate dehydrogenase; PE, plasma exchange; PELOD, Pediatric Logistic Organ Dysfunction; PRISM, Pediatric Risk of Mortality; PT, Prothrombin time; SD, standard deviation.

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