Table 3.
A, Molecular diagnosis consistent with HLH
|
OR |
B, Fulfillment of 5/8 criteria: |
1. Fever |
Temperature > 38.5 C for > 7 days |
2. Splenomegaly |
Spleen tip palpated > 3cm below left costal margin |
3. Cytopenias involving 2 or more lines |
Hb < 9 g/dL, or Plt < 100,000/uL, or ANC <1000/uL |
4. Hypertriglyceridemia and/or hypofibrinogenemia |
fasting triglycerides > 2mmol/L, or >3SD above age-adjusted normal
fibrinogen < 1.5 g/L, or < 3SD below age-adjusted normal |
5. Hemophagocytosis in bone marrow, spleen or lymph nodes |
6. Low or absent NK-cell activity |
determined by 51-Cr release assay |
7. Ferritin > 500 ug/L (84% sensitivity) |
> 10,000 (90% sensitvity, 96% specificity) |
8. soluble CD25 (IL-2 receptor) > 2400 U/mL |
> 2 SD above the age-adjusted mean |
Adapted from: Henter JI, et al. Semin Oncol 1991;18:29-33
Henter JI, et al. Pediatr Blood Cancer 2007; 48:124-13