Table 1.
Simplified scoring system used for diagnosis of autoimmune hepatitis [17].
| Variables | Cut-off | Points |
|---|---|---|
| ANA or SMA | ≥1; 40 | 1 |
| ≥1 : 80 | 2 | |
|
| ||
| Or LKM 1 | ≥1 : 40 | 2 |
|
| ||
| Or SLA | Positive | 1 |
|
| ||
| Ig G | >Upper limit of normal | 1 |
| >1.1x upper limit of normal | 2 | |
|
| ||
| Liver histology | Compatible with AIH# | 1 |
| Typical of AIH$ | 2 | |
|
| ||
| Absence of viral hepatitis∗∗ | Yes | 2 |
|
| ||
| Exclude other causes of acute liver injury: | ||
| (i) Drug induced liver injury (history) | ||
| (ii) Acute hepatitis A (check HAV IgM) | ||
| (iii) Acute hepatitis E (check HEV IgM) | ||
| (iv) Wilson's disease | ||
ANA: anti-nuclear antibodies; SMA: anti-smooth-muscle antibodies; LKM1: liver/kidney microsomal antibody type 1; SLA: antisoluble liver antigen.
∗∗Viral hepatitis: exclusion of viral hepatitis B and hepatitis C. Other viral markers such as Cytomegalovirus, Varicella Zoster virus, Epstein Barr virus, and human immunodeficiency virus (HIV) should be excluded.
Liver Histology.
#Compatible with AIH: chronic hepatitis with lymphocytic infiltration, without typical features.
$Typical of AIH: interface hepatitis, emperipolesis, and hepatic rosette formation.
Definite AIH: a cumulative score ≥ 7.
Probable AIH: a cumulative score = 6.