HScore for Haemophagocytic Lymphohistiocytosis
HScore predicts probability of reactive haemophagocytic syndrome (HLH/MAS). Score ≥169 associated with >93% probability of HLH. Guides early immunosuppressive treatment.
Score interpretation
→ HScore ≥169: >93% probability of HLH. Initiate HLH-94 protocol (dexamethasone + etoposide + cyclosporin if indicated); treat underlying trigger (infection, malignancy, rheumatic); haematology urgent review; bone marrow biopsy; NK cell function; sCD25; consider IVIG.
→ HScore 100–168: Intermediate HLH probability (30–93%). High suspicion; urgent bone marrow; ferritin, fibrinogen, sCD25, NK cell function; rheumatology/haematology joint review; empirical immunosuppression if deteriorating.
→ HScore <100: <30% probability of HLH. Consider alternative diagnoses (infection, malignancy, autoimmune). Complete diagnostic workup; review HScore if clinical picture evolves.
Interpretation bands for the HScore (HLH). Apply clinical judgement and local guidance.
References
Related
Curated clinical cross-links plus same-class fallbacks.
- Sodium Cromoglicate Nasal Spray · Mast Cell Stabiliser — Allergic Rhinitis
- Olopatadine · H1 antihistamine + mast cell stabiliser
- Hydroxycarbamide (Hydroxyurea) · Cytoreductive agent / Sickle cell disease / CML
- Rituximab (Haematology) · Anti-CD20 Monoclonal Antibody
- Crizanlizumab · P-selectin Inhibitor — Sickle Cell Disease
- Voxelotor · Haemoglobin S Polymerisation Inhibitor — Sickle Cell Disease
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Splenomegaly Workup · BSH; BMJ Best Practice
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH
- Neutropenic Sepsis · NICE CG151 2012 / ESMO
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.