ABSTRACT
The diagnosis of autoimmune hepatitis (AIH) can be challenging due to the variable
clinical and laboratory findings. The original diagnostic criteria published in 1993
by the International Autoimmune Hepatitis Group (IAIHG) were revised in 1999 in an
attempt to standardize the diagnosis. However, these criteria are complex and can
be cumbersome in clinical practice. In 2008, simplified diagnostic criteria were reported
to facilitate the bedside diagnosis of AIH. The scoring systems have been evaluated
in several retrospective case series and tested for their ability to reliably diagnose
and exclude AIH. However, the scoring systems did not fare as well in patients with
concomitant cholestatic disease, fatty liver disease, fulminant hepatitis, and pediatric
patients. Both positive and negative predictive values are low in these patients.
Prospective studies are needed to compare the two scoring systems to determine which
(if not all) patients require liver biopsy and which patients would benefit from immunotherapy.
KEYWORDS
Autoimmune hepatitis - revised original scoring system - simplified scoring system
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Ansgar W LohseM.D.
I. Department of Medicine, University Medical Center Hamburg-Eppendorf
Martinistrasse 52, D-20246 Hamburg, Germany
eMail: alohse@uke.de
