Khat (Catha Edulis) as a possible cause of autoimmune hepatitis

Table 1 Patient scores according to the revised criteria for diagnosing autoimmune hepatitis

Parameters	Score	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5	Patient 6
ALP:ALT (or AST) ratio		125/1569	170/1223	187/1957	179/1005	298/1052	59/118
< 1.5	2	2	2	2	2	2	2
1.5-3.0	0
> 3.0	-2
Serum IgG above normal
> 2.0	3	3		3	3	3
1.5-2.0	2						2
1.0-1.5	1
< 1.0	0		0
ANA, SMA or LKM-1
> 1:80	3			3		3
Approximately 1:80	2				2
Approximately 1:40	1
< 1:40	0	0	0				0
AMA positive	-4	Negative	Negative	Negative	Negative	Negative	Negative
Viral hepatitis markers
Positive	-3
Negative	3	3	3	3	3	3	3
Drug History
Positive	-4	-4	-4	-4	-4	-4	-4
Negative	1
Average alcohol intake
< 25 g/d	2	2	2	2	2	2	2
> 60 g/d	-2
Liver histology
Interface hepatitis	3	3	3	3	3	N/A	3
Lymphoplasmacytic infiltrate	1	1	1				1
Rosetting of liver cells	1	1	1	1			1
None of the above	-5
Biliary changes	-3
Other changes	-3
Other autoimmune diseases	2	2 (IDDM)	0	0	0	0	0
Optional additional parameters
Sero positivity-other antibodies	2					2 (ENA+)
HLA DR3 or DR4	1	N/A	N/A	N/A	N/A	N/A	N/A
Pretreatment score		13	8	13	11	11	10

AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ALP: Alkaline phosphatase; ANA: Antinuclear antibodies; SMA: Anti-smooth muscle antibody; LKM-1: Anti-liver/kidney microsomal type 1; AMA: Anti-mitochondrial antibodies; N/A: Not available.