Further multivariate logistic regression analysis indicated that a reduced platelet count (OR 0.966 [0.947, 0.985], P = 0.001), decreased ALT/AST ratio (OR 0.016 [0.001, 0.338], P = 0.008), elevated LDH (OR 1.001 [1.001, 1.002], P = 0.001), and increased DD (OR 1.088 [1.033, 1.146], P = 0.001) are independent risk factors for HLH occurrence in SFTS patients. Here, GPT is linked to hemophagocytic syndrome.