Intensive Care Unit, University Hospital Basel, Switzerland.
Department of Haematology, University Hospital Basel, Switzerland.
Swiss Med Wkly. 2021 Jan 15;151:w20420. doi: 10.4414/smw.2021.20420. eCollection 2021 Jan 18.
The authors present the case of a 58-year-old man with the unique combination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and, later on, haemophagocytic lymphohistiocytosis admitted to the intensive care unit. During his ICU stay the patient developed a variety of complications including acute respiratory distress syndrome, pulmonary embolism, right heart failure and suspected HLH leading to multiorgan failure and death. Despite the proven diagnosis of haemophagocytic lymphohistiocytosis, the excessively high ferritin levels of the patient did not seem fully explained by this diagnosis. Therefore, the authors want to highlight different causes of hyperferritinaemia in critically ill patients and underline the importance of differential diagnoses when interpreting continuously rising ferritin levels.
作者报告了一例 58 岁男性，其独特之处在于严重急性呼吸综合征冠状病毒 2 (SARS-CoV-2) 感染，随后发生噬血细胞性淋巴组织细胞增生症，并入住重症监护病房。在重症监护病房期间，该患者出现多种并发症，包括急性呼吸窘迫综合征、肺栓塞、右心衰竭和疑似噬血细胞性淋巴组织细胞增生症导致的多器官衰竭和死亡。尽管噬血细胞性淋巴组织细胞增生症的诊断得到证实，但患者过高的铁蛋白水平似乎不能完全用该诊断来解释。因此，作者希望强调重症患者高血铁蛋白血症的不同原因，并强调在解释不断升高的铁蛋白水平时进行鉴别诊断的重要性。
