Review Article

Autoimmune Hepatitis: Progress from Global Immunosuppression to Personalised Regulatory T Cell Therapy

Table 1

Simplified scoring system used for diagnosis of autoimmune hepatitis [17].

VariablesCut-offPoints

ANA or SMA≥1; 401
≥1 : 802

Or LKM 1≥1 : 402

Or SLAPositive1

Ig G>Upper limit of normal1
>1.1x upper limit of normal2

Liver histologyCompatible with AIH#1
Typical of AIH2

Absence of viral hepatitisYes2

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.