IL6 and alkaline phosphatase measurement: On one hand, severe systemic inflammation triggers pro-inflammatory cytokines such as IL-1β and IL-6, which stimulate ferritin synthesis, causing a sharp increase in serum ferrtin.[27,28] On the other hand, local inflammation and pancreatic tissue damage lead to necrosis of acinar cells, releasing large amounts of intracellular ferritin into circulation.[29–31] Therefore, the high ferritin levels observed in ICU patients with AP are not just a marker of iron storage but likely reflect the combined effects of systemic inflammation and local tissue injury.