How do you work up a young patient with increasing ferritin and normal TSAT without infectious, inflammatory, or liver disorders?

Ferritin uptrending >1000, no additional lab abnormalities. HFE wildtype. Too young for age-appropriate cancer screening. Asymptomatic except fatigue.

Answer from: Medical Oncologist at Academic Institution

This is a tough one. If the ferritin is increasing and the TSAT is normal and there is no evidence of hemochromatosis, the ONLY possible explanation is some underlying morbidity, inflammatory, rheumatologic, malignant, or infectious is present. In pediatrics, HLH (hemophagocytic lymphohistiocyto...

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Medical Oncologist at Chicago Health Medical Group
Consider lymphohistiocytosis.

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How do you work up a young patient with increasing ferritin and normal TSAT without infectious, inflammatory, or liver disorders?

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