ABSTRACT 676

Abstract

Background and aims: Hemophagocytic Lymphohistiocytosis (HLH) is a syndrome of pathologic immune activation. HLH and sepsis-induced multiple organ failure share similar clinical features and biomarkers. The correct diagnosis is essential for strategizing the management including immune modulation. Ferritin is one of the 8 diagnostic criteria for HLH. Ferritin is made up of 2 types of polypeptide chains, heavy and light. Synthesis of heavy chain ferritin, specifically, is induced by tumor necrosis factor-alpha via the NF-KB pathway. Currently, there is no study on these ferritin subtypes in HLH and sepsis. Aims: The aim of this study is to describe the heavy and light chain ferritins in HLH and septic patients. Methods: Plasma samples of pediatric patients with severe sepsis were collected from a single center, and with HLH from a collaborative multicenter HLH study group. We analyzed light and heavy chain ferritins by using Western blotting, monoclonal antibodies, and radio optical densitometry. Results: We analyzed plasma from 11 severe sepsis and 8 HLH patients. We found the presence of light chain ferritin in the plasma of 2 severe sepsis and 4 HLH patients. We found the presence of heavy chain ferritin in the plasma of all severe sepsis and HLH patients. The concentration of heavy chain ferritin was 3.6 times more in HLH patients compared to severe sepsis patients. Conclusions: Heavy chain ferritin is present in both HLH and severe sepsis patients. Heavy chain ferritin seems to be more elevated in patients with HLH compared to severe sepsis. More studies are warranted.