Suitability of the simplified autoimmune hepatitis score for the diagnosis of autoimmune hepatitis in a German cohort

Abstract

Background: Several years ago the International Autoimmune Hepatitis Group simplified the previous revised original scoring system for diagnosis of autoimmune hepatitis (AIH) into a scoring system based on only four instead of 13 parameters.

Objective: We aimed to evaluate the suitability of the simplified AIH score for diagnosis of AIH in a German cohort with chronic liver diseases.

Methods: In this retrospective single-center study, we compared the accuracy of both AIH scores in 70 patients with AIH and 211 patients with chronic liver diseases (PBC (n = 52), PSC (n = 27), NASH (n = 67), DILI (n = 15), CHB/C (n = 50)). Sensitivity, specificity and predictability of each scoring system were calculated.

Results: Using the simplified AIH score, the sensitivity and specificity of detecting a probable AIH (scores ≥ 6) were 96% and 97% with a positive and negative predictive value of 92% and 99%, respectively. For diagnosis of definite AIH (scores ≥ 7), the sensitivity and specificity were 43% and 100% with a positive and negative predictive value of 97% and 84%, respectively. The concordance with the revised original criteria was 63%. The specificity for excluding AIH was excellent in both scoring system.

Conclusion: The simplified diagnostic criteria allow a reliable diagnosis of AIH in a German cohort.

Keywords: Autoimmune hepatitis (AIH); diagnostic scores; revised original criteria; routine clinical practice; simplified criteria.

Figure 1.

Discrepant autoimmune hepatitis diagnoses based on the revised original (pre-treatment) and the simplified scoring system..

Figure 2.

Discrimination of AIH patients and controls using points scored by the revised original (pre-treatment) and the simplified diagnostic criteria.