Clinical features of autoimmune hepatitis diagnosed based on simplified criteria of the International Autoimmune Hepatitis Group.
BACKGROUND
Recently, simplified diagnostic criteria for autoimmune hepatitis have been proposed.


OBJECTIVE
We aimed to evaluate usefulness of the simplified criteria.


METHODS
We applied the simplified criteria to 176 autoimmune hepatitis patients diagnosed according to the revised scoring system proposed in 1999 (original criteria). Furthermore, in order to compare predictabilities between these two diagnostic criteria, we included 168 patients with other liver disease than autoimmune hepatitis.


RESULTS
Of 176 autoimmune hepatitis patients, 85% were diagnosed with autoimmune hepatitis according to the simplified criteria, and patients diagnosed according to the simplified criteria showed a higher frequency of antinuclear antibodies and/or smooth muscle antibodies of 1:80 or greater and slightly higher serum levels of immunoglobulin G than those diagnosed according to the original criteria. However, 30% of male patients, 23% of patients with acute presentation, 50% of patients showing histological acute hepatitis and 46% of patients negative for antinuclear antibodies at presentation were not diagnosed with autoimmune hepatitis according to the simplified criteria. The simplified criteria showed lower sensitivity (85% vs. 100%) and higher specificity (99% vs. 93%) for autoimmune hepatitis than the original criteria.


CONCLUSIONS
The simplified criteria may be useless for the diagnosis of patients with atypical features, especially patients with histological acute hepatitis.
Miyake
Yasuhiro
Y
Department of Molecular Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Japan. miyakeyasuhiro@hotmail.com
Iwasaki
Yoshiaki
Y
Kobashi
Haruhiko
H
Yasunaka
Tetsuya
T
Ikeda
Fusao
F
Takaki
Akinobu
A
Yamamoto
Kazuhide
K
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000974:Antibodies, Antinuclear / Q000097:blood; D016022:Case-Control Studies; D005260:Female; D019693:Hepatitis, Autoimmune / Q000175:diagnosis*; D006801:Humans; D007074:Immunoglobulin G; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012737:Sex Factors; D055815:Young Adult
D000974:Antibodies, Antinuclear; D007074:Immunoglobulin G