Table 3.
Feature/parameter | Discriminator | Score |
ANA or SMA + | ≥ 1:40 | +11 |
ANA or SMA+ | ≥ 1:80 | +21 |
or LKM + | ≥ 1:40 | +21 |
or SLA/LP + | Any titer | +21 |
IgG or γ-globulins level | > upper limit of normal | +1 |
> 1.1 × upper limit | +2 | |
Liver histology (evidence of hepatitis is a necessary condition) | Compatible with AIH | +1 |
Typical of AIH | +2 | |
Atypical | 0 | |
Absence of viral hepatitis | No | 0 |
Yes | +2 |
Addition of points achieved for all autoantibodies (maximum, 2 points). Definite autoimmune hepatitis: ≥ 7; Probable autoimmune hepatitis: ≥ 6. Typical liver histology for autoimmune hepatitis = each of the following features had to be present, namely interface hepatitis, lymphocytic/lymphoplasmocytic infiltrates in portal tracts and extending into the lobule, emperipolesis (active penetration by one cell into and through a larger cell) and hepatic rosette formation. Compatible liver histology for autoimmune hepatitis = chronic hepatitis with lymphocytic infiltration without all the features considered typical. Atypical = showing signs of another diagnosis, like steatohepatitis. ANA: Antinuclear antibodies; SMA: Smooth muscle autoantibodies; LKM: Liver/kidney microsomal; SLA/LP: Soluble liver antigen or liver pancreas; AIH: Autoimmune hepatitis.