EULARHScore

EULARHScore is a proposed composite scoring system associated with the European League Against Rheumatism (EULAR) intended to quantify the degree of systemic hyperinflammation in rheumatic diseases. It is not an established or validated tool in routine clinical practice, and references to it typically appear in early-stage proposals rather than widely cited guidelines or studies.

The conceptual purpose of EULARHScore is to standardize the assessment of hyperinflammatory states within inflammatory rheumatic conditions, complementing existing disease activity indices. It aims to facilitate risk stratification, guide treatment decisions, and support comparability across multicenter studies and clinical trials that involve inflammatory surges or macrophage activation-like syndromes.

Components of the proposed framework generally blend clinical and laboratory domains. Clinical features may include fever and signs of organ involvement; laboratory markers commonly cited include ferritin, triglycerides, cytopenias, C-reactive protein or ESR, and liver function tests. Imaging findings or organ-specific assessments could also contribute. Each domain is assigned a score, and the total EULARHScore is the sum of these domain scores, creating a continuous metric with a higher total indicating greater hyperinflammation. Specific thresholds and weighting are not standardized and vary among hypothetical proposals.

Validation status remains unsettled, and no consensus cutoffs exist. As a result, EULARHScore is not used for routine diagnosis or treatment decisions. If adopted, it would require formal validation across diverse diseases, clear interpretation guidelines, and integration with existing EULAR recommendations.

See also: HScore for macrophage activation syndrome/HLH, EULAR disease activity indices, inflammatory markers in rheumatic diseases.