Epidemiology and treatment of autoimmune hepatitis

Figures & data

Table 1 Simplified diagnostic criteria for autoimmune hepatitis

Variable	Cut-off	Points	Cut-off	Points
ANA or SMA	≥1/40	1	≥1/80	2
LKM			≥1/40
SLA			Positive
IgG	ULN	1	>1.1 × ULN	2
Histology	Compatible with AIH*	1	Typical of AIH*	2
Absence of viral hepatitis			Yes	2

Notes: Copyright © 2008, John Wiley & Sons. Modified with permission from Hennes EM, Zeniya M, Czaja AJ, et al. Simplified criteria for the diagnosis of autoimmune hepatitis. Hepatology. 2008;48:169–176. Probable AIH: ≥6 points; definite AIH: ≥7 points; maximum number of points for all autoantibodies is 2; total is 8 points.

* Histology

• – Compatible with AIH: chronic hepatitis with lymphocytic infiltration without features considered typical.

• – Typical of AIH:

  1. Interface hepatitis, lymphocytic/lymphoplasmacytic infiltrates in portal tracts and extending in the lobule.

  2. Emperipolesis (active penetration by one cell into and through larger cell).

  3. Hepatic rosette formation.

• – Atypical: showing signs of another diagnosis like NAFLD.

Abbreviations: AIH, autoimmune hepatitis; ANA, antinuclear antibodies; IgG, immunoglobulin G; LKM, liver/kidney membrane microsome; NAFLD, nonalcoholic fatty liver disease; SLA, soluble liver antigen; SMA, smooth muscle antibodies; ULN, upper limit of normal.