HYPERFERRITINEMIA IN THE SALMONELLA TYPHI INFECTION
Ozyurek H*, Uyan AP*, Ertor O**, Simsek E*,
Kocabay K*
*Abant Izzet Baysal University, Department of
Pediatrics
** Abant Izzet Baysal University, Department of
Infectious Disease
Ferritin
is the principal iron storage protein. There are five general categories of
hyperferritinemia; hemochromatosis, inflammatory syndromes, cytolysis,
hemophagocytosis, Still’s disease, and other etiologies
(hereditary hyperferritinemia-cataract syndrome, etc). Some cytokines have
been reported to be responsible for the elevation of ferritin production.
The pathophysiological properties of hyperferritinemia are not yet clear.
A 9
year-old boy was admitted to hospital with the complaint of fever over 38.5
oC lasting more than 10 days. Before admission he was diagnosed as viral
upper respiratory infection and treated with antipyretic and
antiinflammatory drugs. But there was no observation in the control of
fever. Except fever and splenomegaly (palpable 2 cm under the costal
margin) the physical findings were normal. Complete blood count, routine
urine and biochemistry results were in normal. Even though serum iron, iron
binding capacity and, saturation index were normal, ferritin was found very
high in the two dilueted serum specimens(2190 and 2075 ng/ml). In the blood
and stool cultures salmonella typhi was isolated. Bone marrow aspiration
revealed that atypic cell, histiocytic cell accumulation and
hemophagocytosis were not observed. His mother and father ferritin levels
were in normal. The patient was diagnosed as enteric fever. The patient was
put on ceftriaksone treatment. At the 5th day of tr!
eatment his fever resolved. One month after
treatment his ferritin level was found as 128 ng/ml.
In conclusion, this is first reported
hyperferritinemia case due to salomonella typhi infection in the
literature.