Figure 3.

Ferritin levels. Suspected diagnosis varies according to the level of serum ferritin. Serum ferritin levels over 1 000 ng/mL suggest 3 possible diagnoses – liver diseases, infections, and malignancies – some of which exhibit ferritin levels over 3 000 ng/mL. The median level of serum ferritin in adult-onset Still’s disease (AOSD) patients is reportedly 4 752 ng/mL. Extremely high serum ferritin levels >10 000 ng/mL are seen only in severe liver damage, multiple blood transfusions, or hemophagocytic syndrome (HPS). Our patient had an extremely high serum ferritin level of 78 662 ng/mL, which is markedly higher than the mean serum ferritin level of 18 179 ng/mL in AOSD patients with HPS.