The presence of certain clinical findings in a patient with the Hemophagocytic Syndrome may indicate a greater risk for death. The presence of one or more risk factors indicates a patient who requires more aggressive therapy and monitoring.


Risk factors associated with nonsurvival:

(1) age > 30 years

(2) presence of DIC (disseminated intravascular coagulopathy) with fibrin degradation products on admission (> 10 µg/mL)

(3) increased ferritin on admission (> 500 ng/mL)

(4) increased beta-2 microglobulin on admission (> 3 µg/mL, or > 0.3 mg/dL)

(5) anemia and thrombocytopenia on admission (hemoglobin < 10 g/dL, platelet count < 100,000 per µL)

(6) worsening of anemia and thrombocytopenia during hospitalization

(7) elevated total bilirubin with jaundice, increasing during hospitalization

(8) increasing alkaline phosphatase during hospitalization

(9) increased serum tumor necrosis factor levels (> 50 pg/mL)

(10) absence of lymphadenopathy



• The laboratory methods may vary between laboratories, so the precise decision levels should be validated for each methodology.


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