高铁蛋白血症可发生在各种疾病中,使鉴别诊断多样化,往往是致命的。巨噬细胞激活综合征(MAS)是高铁蛋白血症的鉴别诊断,其中系统性巨噬细胞被激活并引起各种症状。许多病例并发噬血细胞综合征,导致全血细胞减少症,这可能是致命的。此外,诊断老年患者的高铁蛋白血症具有挑战性,这种疾病可能会发展成不明原因的发烧。我们报告一例93岁男子吸入性肺炎,其次是间歇性长时间发热,并发异常高铁蛋白血症和白细胞减少。根据他的一般情况,他被诊断出患有非典型的成人斯蒂尔病,并接受类固醇脉冲和托珠单抗治疗,暂时缓解他的症状。然而,患者最终发展为脓毒症,无法得救.老年人群高铁蛋白血症的诊断是复杂的,需要立即注意。然而,侵入性干预可能导致老年患者病情恶化。在社区医院为老年人提供医疗服务的背景下,有必要为处于危急状态的人提供全面的护理,考虑到检查和程序的侵入性程度。
Hyperferritinemia can occur in various diseases, making the differential diagnoses diverse and often fatal. The macrophage-activated syndrome (MAS) is a differential diagnosis of hyperferritinemia in which systemic macrophages are activated and cause various symptoms. Many cases are complicated by hemophagocytic syndrome, causing pancytopenia, which can be fatal. Furthermore, it is challenging to diagnose hyperferritinemia in elderly patients, and the disease may develop into a fever of unknown origin. We report the case of a 93-year-old man with aspiration pneumonia, followed by intermittent prolonged fever complicated by abnormal hyperferritinemia and leukopenia. Based on his general condition, he was diagnosed with atypical adult Still\'s disease and treated with steroid pulses and tocilizumab, temporarily relieving his symptoms. However, the patient eventually developed sepsis and could not be saved. Diagnosis of hyperferritinemia in the elderly population is complex and requires immediate attention. However, invasive intervention may lead to the deterioration of an elderly patient\'s condition. In the context of medical care for the elderly at a community hospital, it is necessary to provide comprehensive care for those in critical condition, considering the degree of invasiveness of examinations and procedures.