title: Utility of simplified criteria for the diagnosis of autoimmune hepatitis in children.
abstract: OBJECTIVE
  Although the diagnostic scoring system of autoimmune hepatitis (AIH) has been used, these criteria are intended mainly as research tools and are complicated to apply. To resolve these difficulties and allow quick diagnosis, a simplified scoring system was proposed in 2007. We retrospectively compared the simplified AIH scoring system with the 1999 revised original AIH scoring system in children.
  
  
  METHODS
  Twenty children (boys/girls 10/10, age 1-15 years, mean age ± SD 8.4 ± 4.4 years) who were diagnosed with AIH based on clinical, biochemical, immunological, and histological data were enrolled in this study. In addition, 36 children with non-AIH liver diseases (boys/girls 22/14, age 1-16 years, mean age ± SD 7.8 ± 4.4 years) were available for evaluation of both the simplified and the 1999 revised scoring system.
  
  
  RESULTS
  The sensitivity and specificity of the 1999 revised scoring system were 100% and 81%, respectively. In contrast, the sensitivity and specificity of the simplified scoring system were 55% and 86%, respectively. Of the 20 children with AIH, 9 (45%) were classified as not having AIH using the simplified scoring system. Of the 9 children, 2 and 7 were classified as having definite AIH and probable AIH using the 1999 revised scoring system, respectively. All 5 children with primary sclerosing cholangitis were graded as having AIH using the simplified AIH criteria and the 1999 revised criteria.
  
  
  CONCLUSIONS
  Although the simplified AIH scoring system has low sensitivity for the diagnosis of AIH in children, the specificity of the simplified AIH scoring system is high. However, the simplified AIH scoring system could not differentiate between AIH and primary sclerosing cholangitis. Therefore, the simplified AIH scoring system does not seem to be a reliable diagnostic tool in children.
authors.affiliation: Department of Pediatrics, Eastern Yokohama Hospital, Yokohama, Kanagawa, Japan.
authors.forename: Eitaro
authors.initials: E
authors.lastname: Hiejima
authors.forename: Haruki
authors.initials: H
authors.lastname: Komatsu
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Sogo
authors.forename: Ayano
authors.initials: A
authors.lastname: Inui
authors.forename: Tomoo
authors.initials: T
authors.lastname: Fujisawa
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015209:Cholangitis, Sclerosing / Q000175:diagnosis; D003937:Diagnosis, Differential; D003938:Diagnostic Techniques, Digestive System; D005260:Female; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000379:methods; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D007166:Immunosuppressive Agents