Review Article
Autoimmune Hepatitis as a Unique Form of an Autoimmune Liver Disease: Immunological Aspects and Clinical Overview
Table 1
Revised scoring system for the diagnosis of autoimmune hepatitis.
| Parameters/features | Score | Notes* |
| Female sex | +2 | | ALP : AST (or ALT) ratio: | | | 1.5 | +2 | 1 | 1.5–3.0 | 0 | | 3.0 | −2 | | Serum globulins or IgG above normal | | | 2.0 | +3 | | 1.5–2.0 | +2 | | 1.0–1.5 | +1 | | 1.0 | 0 | | ANA, SMA, or LKM-1 | | | 1 : 80 | +3 | 2 | 1 : 80 | +2 | | 1 : 40 | +1 | | 1 : 40 | 0 | | AMA positive | −4 | | Hepatitis viral markers: | | | Positive | −3 | 3 | Negative | +3 | | Drug history: | | | Positive | −4 | 4 | Negative | +1 | | Average alcohol intake | | | 25 g/day | +2 | | 60 g/day | −2 | | Liver histology: | | | Interface hepatitis | +3 | | Predominantly lymphoplasmacytic infiltrate | +1 | | Rosetting of liver cells | +1 | | None of the above | −5 | | Biliary changes | −3 | 5 | Other changes | −3 | 6 | Other autoimmune disease(s) | +2 | 7 | Optional additional parameters: | | 8 | Seropositivity for other defined autoantibodies | +2 | 9 | HLA DR3 or DR4 | +1 | 10 | Response to therapy: | | | Complete | +2 | 11 | Relapse | +3 | | Interpretation of aggregate scores: | | | Pretreatment: | | | Definite AIH | >15 | | Probable AIH | 10–15 | | Posttreatment: | | | Definite AIH | >17 | 12 | Probable AIH | 12–17 | |
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[36].
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