SHAP analysis indicated that APTT contributed most to the prediction, while RCS analysis revealed a monotonically increasing relationship between APTT and mortality risk, with elevated MCH levels demonstrating a significant protective trend.<h4>Conclusion</h4>The analytical strategy integrating the Boruta algorithm and LCA effectively identifies clinical subtypes of pediatric HLH with distinct mortality risk trajectories based on routine peripheral blood indicators. The gene discussed is PMCH; the disease is hemophagocytic syndrome.