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CASE REPORTS
JOURNAL ARTICLE
Falsely decreased ferritin concentrations in two patients with haemophagocytic lymphohistiocytosis: A case report.
Annals of Clinical Biochemistry 2019 January
The high-dose hook effect, or prozone effect, can lead to negative or falsely lowered plasma ferritin results. Here, cases of a 16-year-old boy and a 70-year-old woman with haemophagocytic lymphohystiocytosis with extremely high concentrations of plasma ferritin (387,000 μg/L and 138,000 μg/L, respectively) are presented. In both cases, falsely lowered ferritin results were reported without any analyser flag. This article emphasizes the importance of recognition of the high-dose hook effect, since a watertight solution is lacking.
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