{"id":83,"date":"2009-02-28T14:34:41","date_gmt":"2009-02-28T14:34:41","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/reuautohep\/"},"modified":"2025-05-14T20:58:10","modified_gmt":"2025-05-14T20:58:10","slug":"reuautohep","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/reuautohep\/","title":{"rendered":"Diagnostic Criteria for Autoimmune Hepatitis (AIH)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Autoimmune hepatitis (AIH) is characterized by inflammatory liver histology, circulating non-organ-specific autoantibodies, and increased levels of immunoglobulin (Ig) G in the absence of a known etiology.<br \/>\n<!--more--><\/p>\n<table style=\"border-collapse: collapse; width: 100%; height: 670px;\" border=\"1\">\n<tbody>\n<tr style=\"height: 56px;\">\n<td style=\"border: 1pt solid windowtext; padding: 0cm 5.4pt; width: 149.6pt; height: 95px;\" rowspan=\"2\" valign=\"top\" width=\"199\">\n<p class=\"MsoNormal\"><strong> Requisites<\/strong><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 299.3pt; height: 56px;\" colspan=\"2\" valign=\"top\" width=\"399\">\n<p class=\"MsoNormal\" style=\"text-align: center;\" align=\"center\"><strong> Diagnostic Criteria<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 39px;\">\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 39px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\"><strong> Definite<\/strong><\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 39px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\"><strong> Probable<\/strong><\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 95px;\">\n<td style=\"padding: 0cm 5.4pt; width: 149.6pt; height: 95px;\" valign=\"top\" width=\"199\">\n<p class=\"MsoNormal\">No genetic liver disease<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 95px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Normal alpha1 antitrypsin phenotype<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Normal serum ceruloplasmin, iron, and ferritin levels<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 95px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Partial alpha1 antitrypsin deficiency<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Nonspecific serum copper, ceruloplasmin, iron, and\/or ferritin abnormalities<\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 80px;\">\n<td style=\"padding: 0cm 5.4pt; width: 149.6pt; height: 80px;\" valign=\"top\" width=\"199\">\n<p class=\"MsoNormal\">No active viral infection<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 80px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\">No markers of current infection with hepatitis A, B, and C viruses<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 80px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\">No markers of current infection with hepatitis A, B, and C viruses<\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 80px;\">\n<td style=\"padding: 0cm 5.4pt; width: 149.6pt; height: 80px;\" valign=\"top\" width=\"199\">\n<p class=\"MsoNormal\">No toxic or alcohol injury<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 80px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\">Daily alcohol &lt; 25 g\/d and no recent use of hepatotoxic drugs<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 80px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\">Daily alcohol &lt; 50 g\/d and no recent use of hepatotoxic drugs<\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 120px;\">\n<td style=\"padding: 0cm 5.4pt; width: 149.6pt; height: 120px;\" valign=\"top\" width=\"199\">\n<p class=\"MsoNormal\">Laboratory features<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 120px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Predominant serum aminotransferase abnormality<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Globulin, gamma-globulin or immunoglobulin G level &gt;\/= 1.5 times normal<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 120px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Predominant serum aminotransferase abnormality<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Hypergammaglobulinemia of any degree<\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 104px;\">\n<td style=\"padding: 0cm 5.4pt; width: 149.6pt; height: 104px;\" valign=\"top\" width=\"199\">\n<p class=\"MsoNormal\">Autoantibodies<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 104px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\">ANA, SMA, or anti-LKM1 &gt;\/= 1:80 in adults and &gt;\/=1:20 in children; no AMA<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 104px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\">ANA, SMA, or anti-LKM1 &gt;\/= 1:40 in adults or other autoantibodies*<\/p>\n<\/td>\n<\/tr>\n<tr style=\"height: 96px;\">\n<td style=\"padding: 0cm 5.4pt; width: 149.6pt; height: 96px;\" valign=\"top\" width=\"199\">\n<p class=\"MsoNormal\">Histologic findings<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 96px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Interface hepatitis<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">No biliary lesions, granulomas, or prominent changes suggestive of another disease<\/p>\n<\/td>\n<td style=\"padding: 0cm 5.4pt; width: 149.65pt; height: 96px;\" valign=\"top\" width=\"200\">\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Interface hepatitis<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">No biliary lesions, granulomas, or prominent changes suggestive of another disease<\/p>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">Abbreviation: AMA, antimitochondrial antibodies.<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\">*Includes perinuclear anti-neutrophil cytoplasmic antibodies and the not generally available antibodies to soluble liver antigen\/liver pancreas, actin, liver cytosol type 1, and asialoglycoprotein receptor.<\/p>\n<p>&nbsp;<\/p>\n<p class=\"MsoNormal\" style=\"margin-top: 0pt; margin-bottom: 0pt;\"><strong>Diagnostic Scoring System for Atypical Autoimmune Hepatitis in Adults<\/strong><\/p>\n<table id=\"AutoNumber1\" style=\"border-collapse: collapse;\" border=\"1\" width=\"100%\">\n<tbody>\n<tr>\n<td width=\"33%\"><strong> Category<\/strong><\/td>\n<td style=\"text-align: center;\" width=\"33%\"><strong> Factor<\/strong><\/td>\n<td align=\"center\" width=\"34%\"><strong> Score<\/strong><\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Gender<\/td>\n<td style=\"text-align: center;\" width=\"33%\">Female<\/td>\n<td align=\"center\" width=\"34%\">+2<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Alk Phos:AST (or ALT) ratio<\/td>\n<td style=\"text-align: center;\" width=\"33%\">&gt;3<br \/>\n&lt;1.5<\/td>\n<td align=\"center\" width=\"34%\">-2<br \/>\n+2<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Gamma-globulin or IgG (times above upper limit of normal)<\/td>\n<td style=\"text-align: center;\" width=\"33%\">&gt;2.0<br \/>\n1.5-2.0<br \/>\n1.0-1.5<br \/>\n&lt;1.0<\/td>\n<td align=\"center\" width=\"34%\">+3<br \/>\n+2<br \/>\n+1<br \/>\n0<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">ANA, SMA, or anti-LKM1 titers<\/td>\n<td style=\"text-align: center;\" width=\"33%\">&gt;1:80<br \/>\n1:80<br \/>\n1:40<br \/>\n&lt;1:40<\/td>\n<td align=\"center\" width=\"34%\">+3<br \/>\n+2<br \/>\n+1<br \/>\n0<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">AMA<\/td>\n<td style=\"text-align: center;\" width=\"33%\">Positive<\/td>\n<td align=\"center\" width=\"34%\">-4<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Viral markers of active infection<\/td>\n<td style=\"text-align: center;\" width=\"33%\">Positive<br \/>\nNegative<\/td>\n<td align=\"center\" width=\"34%\">-3<br \/>\n+3<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Hepatotoxic drugs<\/td>\n<td style=\"text-align: center;\" width=\"33%\">Yes<br \/>\nNo<\/td>\n<td align=\"center\" width=\"34%\">-4<br \/>\n+1<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Alcohol<\/td>\n<td style=\"text-align: center;\" width=\"33%\">&lt;25 g\/d<br \/>\n&gt;60 g\/d<\/td>\n<td align=\"center\" width=\"34%\">+2<br \/>\n-2<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Concurrent immune disease<\/td>\n<td style=\"text-align: center;\" width=\"33%\">Any nonhepatic disease of an immune nature<\/td>\n<td align=\"center\" width=\"34%\">+2<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Other autoantibodies*<\/td>\n<td style=\"text-align: center;\" width=\"33%\">Anti-SLA\/LP, actin, LC1, pANCA<\/td>\n<td align=\"center\" width=\"34%\">+2<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Histologic features<\/td>\n<td style=\"text-align: center;\" width=\"33%\">Interface hepatitis<br \/>\nPlasma cells<br \/>\nRosettes<br \/>\nNone of above<br \/>\nBiliary changes<br \/>\nAtypical features<\/td>\n<td align=\"center\" width=\"34%\">+3<br \/>\n+1<br \/>\n+1<br \/>\n-5<br \/>\n-3<br \/>\n-3<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">HLA<\/td>\n<td style=\"text-align: center;\" width=\"33%\">DR3 or DR4<\/td>\n<td align=\"center\" width=\"34%\">+1<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\">Treatment response<\/td>\n<td style=\"text-align: center;\" width=\"33%\">Remission alone<br \/>\nRemission with relapse<\/td>\n<td align=\"center\" width=\"34%\">+2<br \/>\n+3<\/td>\n<\/tr>\n<tr>\n<td width=\"33%\"><strong> Pretreatment score<\/strong><br \/>\nDefinite diagnosis<br \/>\nProbable diagnosis<br \/>\n<strong>Posttreatment score<\/strong><br \/>\nDefinite diagnosis<br \/>\nProbable diagnosis<\/td>\n<td width=\"33%\"><\/td>\n<td align=\"center\" width=\"34%\">\n&gt;15<br \/>\n10-15<\/p>\n<p><span style=\"text-align: start;\">&gt;17<\/span><br style=\"text-align: start;\" \/><span style=\"text-align: start;\">12-17<\/span><\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p class=\"MsoNormal\">Abbreviations: Alk phos, serum alkaline phosphatase level; AST, serum aspartate aminotransferase level; ALT, serum alanine aminotransferase level; IgG, serum immunoglobulin G level; AMA, antimitochondrial antibodies; HLA, human leukocyte antigen.<\/p>\n<p>&nbsp;<\/p>\n<p><strong>References:<\/strong><\/p>\n<ol>\n<li class=\"MsoNormal\">Czaja AJ, Freese DK; American Association for the Study of Liver Disease. Diagnosis and treatment of autoimmune hepatitis. Hepatology 2002 Aug;36(2):479-97 <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/12143059\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li class=\"MsoNormal\">Alvarez F, Berg PA, Bianchi FB, Bianchi L, Burroughs AK, Cancado EL, Chapman RW, Cooksley WG, Czaja AJ, Desmet VJ, Donaldson PT, Eddleston AL, Fainboim L, Heathcote J, Homberg JC, Hoofnagle JH, Kakumu S, Krawitt EL, Mackay IR, MacSween RN, Maddrey WC, Manns MP, McFarlane IG, Meyer zum Buschenfelde KH, Zeniya M, et al. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol\u00a0 1999 Nov;31(5):929-38 <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/10580593\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created: Feb 18, 2006<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"","_lmt_disable":"","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[45],"tags":[1746,250,251,16,15,14,1413,1144,1070],"class_list":["post-83","post","type-post","status-publish","format-standard","hentry","category-rheumatology","tag-aih","tag-autoimmune","tag-autoinmune","tag-criteria","tag-criterios","tag-diagnostic","tag-gastroenterology","tag-hepatitis","tag-rheumatology"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/83","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=83"}],"version-history":[{"count":7,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/83\/revisions"}],"predecessor-version":[{"id":8838,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/83\/revisions\/8838"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=83"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=83"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=83"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}