🧬 HScore (Hemophagocytic Syndrome/HLH Probability)
UseEnter temperature, ferritin, triglycerides, fibrinogen and AST, and select immunosuppression status, organome…
SourceFardet L, et al. Development and validation of the HScore, a score for the diagnosis of reactive he…
This-shift next steps
After scoring: open the scene pack, peer scores, and the matching pathway. Local reference — no HIS write.
Paste the link in Slack, Teams, X, or LinkedIn — the preview image comes from this page’s Open Graph card.
Methodology · worked example, guidelines & full notes
Sepsis, severe infection, and other hyperinflammatory states overlap with HLH, so the score complements rather than replaces sIL-2R, NK-cell activity, marrow review, and identification of the trigger.
When to use
Enter temperature, ferritin, triglycerides, fibrinogen and AST, and select immunosuppression status, organomegaly, number of cytopenic lineages, and marrow hemophagocytosis; the tool returns a 0–337 score and probability band.
How it works
Weighted sum of nine items (immunosuppression 18; temperature ≤38.4 = 0 / 38.4–39.4 = 33 / >39.4 = 49; organomegaly 0/23/38; cytopenias 0/24/34; ferritin <2000 = 0 / 2000–6000 = 35 / >6000 = 50; triglycerides <1.5 = 0 / 1.5–4 = 44 / >4 = 64; fibrinogen ≤2.5 g/L = 30; AST ≥30 = 19; marrow hemophagocytosis 35). A cutoff ≈169 maximizes accuracy.
Key points
- Sepsis, severe infection, and other hyperinflammatory states overlap with HLH, so the score complements rather than replaces sIL-2R, NK-cell activity, marrow review, and identification of the trigger.
- Ferritin and triglycerides carry the most weight, so trending these values can support an evolving diagnosis when the initial score is intermediate.
References
Worked calculation
The values below come from this tool's own example placeholders and are computed server-side with the formula shown on this page, so the arithmetic can be checked quickly. It demonstrates how to substitute values only — it is not clinical advice and not a real case.
| Known immunosuppression (HIV/long-term immunosuppressants) | Yes |
|---|---|
| Temperature | 39 °C |
| Organomegaly | Hepatomegaly or splenomegaly (23) |
| Cytopenic lineages (Hb≤9.2/WBC≤5000/PLT≤110k) | 2 lineages (24) |
| Ferritin | 3000 ng/mL |
| Triglycerides | 3.0 mmol/L |
| Fibrinogen | 2.0 g/L |
| AST | 60 U/L |
| Hemophagocytosis on bone marrow | Yes |
→HScore261/337
- Interpretation：Probability >99%
- Common cutoff：≥169
| Known immunosuppression (HIV/long-term immunosuppressants) | Yes |
|---|---|
| Temperature | 39 °C |
| Organomegaly | None (0) |
| Cytopenic lineages (Hb≤9.2/WBC≤5000/PLT≤110k) | 1 lineage (0) |
| Ferritin | 3000 ng/mL |
| Triglycerides | 3.0 mmol/L |
| Fibrinogen | 2.0 g/L |
| AST | 60 U/L |
| Hemophagocytosis on bone marrow | Yes |
→HScore214/337
- Interpretation：Suggests HLH (≥169)
- Common cutoff：≥169
Verification & sources · governance
FAQ
Frequently asked questions
- What are the limits and cautions when using HScore (Hemophagocytic Syndrome/HLH Probability)?
- For licensed clinicians and clinical researchers. Interpret results with history, investigations and local protocols; not a diagnosis or prescription, and not a substitute for multidisciplinary decision-making or local guidelines.
- Does HScore (Hemophagocytic Syndrome/HLH Probability) upload patient data? Where is it calculated?
- Calculation runs locally in the browser; inputs and results are not uploaded. For licensed clinicians only; interpret with history, investigations and local protocols — not a diagnosis or prescription.
- How is HScore (Hemophagocytic Syndrome/HLH Probability) calculated in practice? Can you show a worked example?
- Inputs: Known immunosuppression (HIV/long-term immunosuppressants) Yes, Temperature 39 °C, Organomegaly Hepatomegaly or splenomegaly (23), Cytopenic lineages (Hb≤9.2/WBC≤5000/PLT≤110k) 2 lineages (24), Ferritin 3000 ng/mL, Triglycerides 3.0 mmol/L, Fibrinogen 2.0 g/L, AST 60 U/L… → Result: HScore 261 /337（Interpretation: Probability >99%, Common cutoff: ≥169） Inputs: Known immunosuppression (HIV/long-term immunosuppressants) Yes, Temperature 39 °C, Organomegaly None (0), Cytopenic lineages (Hb≤9.2/WBC≤5000/PLT≤110k) 1 lineage (0), Ferritin 3000 ng/mL, Triglycerides 3.0 mmol/L, Fibrinogen 2.0 g/L, AST 60 U/L… → Result: HScore 214 /337（Interpretation: Suggests HLH (≥169), Common cutoff: ≥169）