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33; 95% CI1.04-18.1; P=.033). By risk stratifying our cohort, we identified changes in ferritin levels to be the most significant prognostic factor of 30-day mortality among other risk factors. Further investigating the prognostic utility of ferritin showed that increasing ferritin during the 1st week of admission (data available for 44 patients) was the only significant predictor of 30-day mortality. To the best of our knowledge, this is the first study reporting changes in ferritin to be a predictor for early death in adult HLH. C