We report on a seventeen year old @entity1 with persistent @entity221 of unknown origin. An initial episode of @entity490 led to laparotomy and appendectomy, which did not reveal any pathological findings. In the course of the next 3 weeks, the @entity1 's general condition progressively deteriorated. Despite extensive diagnostics, no explanation was found. In summary, the @entity1 was cared for by five different departments in two hospitals before she was admitted to our @entity1 's Hospital. We too were initially misguided by the clinical picture of an @entity166 and treated the @entity1 unsuccessfully with antibiotics. The clue in this case was the finding of a markedly elevated level of serum ferritin. While a normal upper value of less than 400 microg/l is reported, our @entity1 displayed levels above 60,000 microg/l. Such extreme elevations of serum ferritin have been almost exclusively reported for @entity9058 , as @entity9058 ( @entity9058 ). In @entity9058 , impaired cytolytic function of T cells and natural killer cells leads to a state of hyperinflammation. We treated our @entity1 with immunoglobulins and corticosteroids. Simultaneously, we started immunomodulatory therapy with oral @entity205 . The clinical response to this treatment was remarkable. The @entity1 's general condition stabilized quickly and the @entity221 vanished. Additionally, the recovery was accompanied by a normalization of laboratory findings. In conclusion, @entity9058 is a potentially life-threatening disease, which has to be considered in cases with @entity221 of unknown origin. In our case, the diagnostic clue was an extreme elevation of ferritin.

Hyperferritinemia as the diagnostic clue in life-threatening XXXX .

@entity1 :: ('9606', 'Species') :: ['girl', 'Children', 'patient', 'child'] @entity9058 :: ('MESH:D051359', 'Disease') :: ['hemophagocytic syndromes', 'HLH', 'hemophagocytic lymphohistiocytosis'] @entity221 :: ('MESH:D005334', 'Disease') :: ['fever'] @entity205 :: ('MESH:D016572', 'Chemical') :: ['cyclosporine A'] @entity490 :: ('MESH:D015746', 'Disease') :: ['abdominal pain'] @entity166 :: ('MESH:D003141', 'Disease') :: ['infectious disease']
@entity9058 :: (MESH:D051359,Disease) :: ['hemophagocytic lymphohistiocytosis']
