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

• Published in: United European gastroenterology journal 2018-03, Vol.6 (2), p.247-254
• Main Authors: Wobser, Hella, Paur, Tanja, Schnoy, Elisabeth, Hartl, Janine, Kirchner, Gabriele I
• Format: Article
• Language: English
• Subjects: Autoimmune hepatitis (AIH); diagnostic scores; Original; revised original criteria; routine clinical practice; simplified criteria
• ISSN: 2050-6406; 2050-6414
• DOI: 10.1177/2050640617711632

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.