Similarities between hemophagocytic lymphohistiocytosis (HLH) 2004 criteria and features of viral hemorrhagic fever (VHF). Adapted from Chatham and Cron. The Rheumatologist 2014;8:1,21–236; with permission.
| HLH-04 Criteria | Features of VHF |
|---|---|
| Fever | Routinely |
| Splenomegaly | Sometimes |
| Bicytopenia or pancytopenia | Frequently |
| Hypertryglyceridemia or hypofibrinogenemia | Both have been reported for some hemorrhagic fever viruses |
| Hemophagocytosis on biopsy | Yes, for the viruses studied |
| Hyperferritinemia (> 500 ng/ml) | Yes, often > 10,000 ng/ml |
| Elevated soluble CD25 | Yes, for the viruses studied |
| Absence of decreased natural killer cell function | Poorly studied to date |