Evaluation of autoimmune phenomena in patients with nonalcoholic fatty liver disease on the basis of liver pathology

Table 1 Comprehensive diagnosis score system for autoimmune hepatitis (1999)

Parameters/clinical characteristics	Scoring	Parameters/clinical characteristics	Scoring
Women	+2	Drug history
Ratio of ALP (normal upper limit multiple) to AST (or ALT) (normal upper limit multiple)		Positive	-4
< 1.5	+2	Negative	+1
1.5-3.0	0	Average alcohol intake (g/d)
> 3.0	-1	< 25	+2
Serum γ-Ratio of globulin or IgG to normal value		> 60	-2
> 2.0	+3	Histological examination of the liver
1.5-2.0	+2	Interfacial hepatitis	+3
1.0-1.5	+1	Mainly lymphocyte-plasma cells	+1
< 1.0	0	Hepatocytes showed rosette-like changes	+1
ANA, ASMA or LKM-1 titer		No such manifestations	-5
> 1:80	+3	Bile duct alterations	-3
1:80	+2	Other changes	-3
1:40	+1	Other immune diseases	+2
< 1:40	0	Other available parameters
AMA positive	-4	Other specific autoantibodies (SLA/LP, LC-1, ASGPR, pANCA) are positive	+2
Hepatitis virus markers		HLA-DR3 or DR4	+1
Positive	-3	Response to treatment
Negative	+3	Completely; recurrence	+2; +3
Interpretation of total points
Before treatment		Before treatment
Clear AIH	≥ 16	Clear AIH	≥ 18
Possible AIH	10-15	Possible AIH	12-17

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; ALP: Alkaline phosphatase; ANA: Antinuclear antibody; AMA: Anti-mitochondrial antibody; ASMA: Anti-smooth muscle antibody; LKM-1: Anti-liver-kidney microsome type 1; AIH: Autoimmune hepatitis.