Hyperferritinemia in children hospitalized with scrub typhus
Abstract Background Hyperferritinemia is increasingly associated with mortality in sepsis. Studies estimating the prevalence of hyperferritinemia in pediatric scrub typhus are limited. Methods This was a secondary analysis of a prospective observational study (FERRIS) from a tertiary care teaching h...
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doaj-131343a40a21445ba948bac2f20a10722021-02-21T12:28:06ZengBMCTropical Medicine and Health1349-41472021-02-014911810.1186/s41182-021-00304-4Hyperferritinemia in children hospitalized with scrub typhusVijai Williams0Nisha Menon1Prateek Bhatia2Manisha Biswal3Sreejesh Sreedharanunni4Muralidharan Jayashree5Karthi Nallasamy6Division of Pediatric Emergency and Intensive care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & ResearchDivision of Pediatric Emergency and Intensive care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & ResearchDivision of Pediatric Hematology, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & ResearchDepartment of Medical Microbiology, Postgraduate Institute of Medical Education & ResearchDepartment of Hematology, Postgraduate Institute of Medical Education & ResearchDivision of Pediatric Emergency and Intensive care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & ResearchDivision of Pediatric Emergency and Intensive care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & ResearchAbstract Background Hyperferritinemia is increasingly associated with mortality in sepsis. Studies estimating the prevalence of hyperferritinemia in pediatric scrub typhus are limited. Methods This was a secondary analysis of a prospective observational study (FERRIS) from a tertiary care teaching hospital in North India where 72 children with confirmed scrub typhus, 4 (5.5%) PCR positive, 55 (76.4%)-IgM ELISA positive, and 13 (18.1%)-both PCR and ELISA positive, were analyzed. Serum ferritin was measured in 62 children to identify the prevalence of hyperferritinemia and determine its association with mortality. Results Hyperferritinemia (> 500 μg/L) was seen in 72.6% [n = 45] children; 26 (41.9%) were mild (500–2000 μg/L), 13 (21%) were moderate (2000–10,000 μg/L), and 6 (9.7%) were severe (> 10,000 μg/L). Early presentation to hospital (≤ 7 days of febrile illness) had more survivors than late presentation (> 7 days). Non-survivors had significantly higher PRISM III, PELOD-2, hyperlactatemia, hypoalbuminemia, organ dysfunction, need for mechanical ventilation, and need of RRT. Ferritin had poor sensitivity and specificity in predicting survival with AUC of 0.56. Organ dysfunction and risk scores as PRISM III, PELOD 2, and VIS at admission were better predictors with AUC (95% CI) of 0.72 (0.56, 0.89), 0.77 (0.63, 0.92), and 0.90 (0.78, 1.0) respectively. Conclusions Hyperferritinemia is common in scrub typhus but it did not predict survival. Organ dysfunction and risk scores were better predictors of mortality than ferritin.https://doi.org/10.1186/s41182-021-00304-4PediatricFerritinScrub typhusMortalitySepsis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Vijai Williams Nisha Menon Prateek Bhatia Manisha Biswal Sreejesh Sreedharanunni Muralidharan Jayashree Karthi Nallasamy |
spellingShingle |
Vijai Williams Nisha Menon Prateek Bhatia Manisha Biswal Sreejesh Sreedharanunni Muralidharan Jayashree Karthi Nallasamy Hyperferritinemia in children hospitalized with scrub typhus Tropical Medicine and Health Pediatric Ferritin Scrub typhus Mortality Sepsis |
author_facet |
Vijai Williams Nisha Menon Prateek Bhatia Manisha Biswal Sreejesh Sreedharanunni Muralidharan Jayashree Karthi Nallasamy |
author_sort |
Vijai Williams |
title |
Hyperferritinemia in children hospitalized with scrub typhus |
title_short |
Hyperferritinemia in children hospitalized with scrub typhus |
title_full |
Hyperferritinemia in children hospitalized with scrub typhus |
title_fullStr |
Hyperferritinemia in children hospitalized with scrub typhus |
title_full_unstemmed |
Hyperferritinemia in children hospitalized with scrub typhus |
title_sort |
hyperferritinemia in children hospitalized with scrub typhus |
publisher |
BMC |
series |
Tropical Medicine and Health |
issn |
1349-4147 |
publishDate |
2021-02-01 |
description |
Abstract Background Hyperferritinemia is increasingly associated with mortality in sepsis. Studies estimating the prevalence of hyperferritinemia in pediatric scrub typhus are limited. Methods This was a secondary analysis of a prospective observational study (FERRIS) from a tertiary care teaching hospital in North India where 72 children with confirmed scrub typhus, 4 (5.5%) PCR positive, 55 (76.4%)-IgM ELISA positive, and 13 (18.1%)-both PCR and ELISA positive, were analyzed. Serum ferritin was measured in 62 children to identify the prevalence of hyperferritinemia and determine its association with mortality. Results Hyperferritinemia (> 500 μg/L) was seen in 72.6% [n = 45] children; 26 (41.9%) were mild (500–2000 μg/L), 13 (21%) were moderate (2000–10,000 μg/L), and 6 (9.7%) were severe (> 10,000 μg/L). Early presentation to hospital (≤ 7 days of febrile illness) had more survivors than late presentation (> 7 days). Non-survivors had significantly higher PRISM III, PELOD-2, hyperlactatemia, hypoalbuminemia, organ dysfunction, need for mechanical ventilation, and need of RRT. Ferritin had poor sensitivity and specificity in predicting survival with AUC of 0.56. Organ dysfunction and risk scores as PRISM III, PELOD 2, and VIS at admission were better predictors with AUC (95% CI) of 0.72 (0.56, 0.89), 0.77 (0.63, 0.92), and 0.90 (0.78, 1.0) respectively. Conclusions Hyperferritinemia is common in scrub typhus but it did not predict survival. Organ dysfunction and risk scores were better predictors of mortality than ferritin. |
topic |
Pediatric Ferritin Scrub typhus Mortality Sepsis |
url |
https://doi.org/10.1186/s41182-021-00304-4 |
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