Table 8.

Differential diagnosis of highly increased serum ferritin levels (>2× normal)

Infectious Causes	Noninfectious Causes
Acute •Legionnaires' disease •WNEChronic •HIV•CMV •TB	Malignancies •Preleukemias •Lymphomas •Multiple myeloma •Hepatomas •Breast cancer •Colon cancer •Prostate cancer •Lung cancer •Liver/CNS metastases
	Myeloproliferative disorders
	Rheumatic/inflammatory disorders •Rheumatoid arthritis •Adult Still's disease •SLE •TA
	Renal disease •Acute renal failure •Chronic renal failure
	Liver disease •Hemochromatosis •Cirrhosis •α1-antitrypsin deficiency •CAH •Cholestatic jaundice
	Miscellaneous •Sickle cell anemia •Multiple blood transfusions

Abbreviations: CAH, chronic acute hepatitis; CNS, central nervous system; SLE, systemic lupus erythematosus; TA, temporal arteritis, TB, active tuberculosis; WNE, West Nile encephalitis.

Adapted from Cunha CB. Differential diagnosis of infectious disease. In: Cunha BA, editor. Antibiotic essentials. 9th edition. Sudbury (MA): Jones & Bartlett; 2010.