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Hscore

HScore is a clinical scoring system designed to estimate the probability that a patient has hemophagocytic lymphohistiocytosis (HLH), particularly in adults. It was developed by Fardet and colleagues and published in 2014 as a tool to support diagnosis in the setting of suspected HLH.

The score incorporates nine variables: known underlying immunosuppression; fever; organomegaly (hepatosplenomegaly); cytopenias affecting at least two

Validation studies in adult populations have shown good discrimination for HLH, but the score has limitations.

See also: Hemophagocytic lymphohistiocytosis, HLH-2004 diagnostic criteria.

of
three
blood
cell
lineages;
ferritin
level;
triglyceride
level;
fibrinogen
level;
aspartate
aminotransferase
level;
and
evidence
of
hemophagocytosis
on
bone
marrow
examination.
Each
variable
is
assigned
a
weighted
value,
and
the
sum
yields
the
HScore,
which
correlates
with
the
probability
of
HLH.
A
higher
total
indicates
a
higher
likelihood
of
HLH;
in
clinical
practice
a
cutoff
is
used
to
guide
further
testing
and
treatment
decisions.
It
is
not
a
stand-alone
diagnostic
test
and
should
be
interpreted
in
the
clinical
context
alongside
other
laboratory
findings
and
criteria.
Availability
of
some
laboratory
measurements
and
the
need
for
bone
marrow
assessment
can
limit
use,
and
the
score
may
be
affected
by
conditions
that
mimic
HLH,
such
as
severe
infections
or
inflammatory
diseases.