Fulfillment of five out of the eight criteria below:

Fever (defined as a temperature >100.3 °F, >38 °C)
Enlargement of the spleen
Decreased blood cell counts affecting at least two of three lineages in the peripheral blood:
Haemoglobin <9 g/100 ml (in infants <4 weeks: haemoglobin <10 g/100 ml) (anemia)
Platelets <100×109/L (thrombocytopenia)
Neutrophils <1×109/L (neutropenia)
High blood levels of triglycerides (fasting, greater than or equal to 265 mg/100 ml) and/or decreased amounts of fibrinogen in the blood (≤ 150 mg/100 ml)
Ferritin ≥ 500 ng/ml
Haemophagocytosis in the bone marrow, spleen or lymph nodes
Low or absent natural killer cell activity
Soluble CD25 (soluble IL-2 receptor) >2400 U/ml (or per local reference laboratory)In addition, in the case of familial HLH, no evidence of malignancy should be apparent. Not all five out of eight criteria are required for diagnosis of HLH in adults, and a high index of suspicion is required for diagnosis as delay results in increased mortality. The diagnostic criteria were developed in pediatric populations and have not been validated for adult HLH patients. Attempts to improve diagnosis of HLH have included use of the HScore, which can be used to estimate an individuals risk of HLH. In adults, soluble IL-2 receptor has been found to be a very sensitive marker for HLH, demonstrating 100% sensitivity for ruling out HLH below a cutoff of 2400 U/mL and optimal cutoff for ruling in at 2515 U/mL (sensitivity, 100%; specificity, 72.5%), with 93% specificity at >10 000 U/mL.
A Bartons fracture is a type of wrist injury where there is a broken bone associated with a dislocated bone in the wrist, typically occurring after falling on top of a bent wrist. It is an intra-articular fracture of the distal radius with dislocation of the radiocarpal joint.There exist two types of Bartons fracture – dorsal and palmar, the latter being more common. The Bartons fracture is caused by a fall on an extended and pronated wrist increasing carpal compression force on the dorsal rim. Intra-articular component distinguishes this fracture from a Smiths or a Colles fracture. Treatment of this fracture is usually done by open reduction and internal fixation with a plate and screws, but occasionally the fracture can be treated conservatively. Eponym
It is named after John Rhea Barton (1794–1871), an American surgeon who first described this in 1838. Additional images
References
External links
01217 at CHORUS