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©The Author(s) 2016.
World J Gastroenterol. May 21, 2016; 22(19): 4651-4661
Published online May 21, 2016. doi: 10.3748/wjg.v22.i19.4651
Published online May 21, 2016. doi: 10.3748/wjg.v22.i19.4651
Table 1 Studies of incidence and prevalence of autoimmune hepatitis
Ref. | Year | Cases | Incidence/100000 | Prevalence/100000 |
Toda et al[10] | 1997 | 496 | 0.8 | - |
Whalley et al[125] | 2007 | 200 | 3.0 | - |
Werner et al[9] | 2008 | 473 | 0.85 | 10.7 |
Grønbæk et al[7] | 2014 | 1721 | 1.68 | 23.9 |
Gerven et al[8] | 2014 | 1313 | 1.1 | 18.3 |
Ngu et al[39] | 2010 | 138 | 2.0 | 24.5 |
Delgado et al[126] | 2013 | 100 | 0.67 | 11.0 |
Primo et al[127] | 2004 | 13 | 1.37 | 11.61 |
Hurlburt et al[11] | 2002 | 77 | - | 42.9 |
Table 2 Presentation and symptoms in auto immune hepatitis
Acute hepatitis | |
Chronic hepatitis | |
Hepatomegaly | |
Splenomegaly | |
Spider naevi | |
Palmar erythema | |
Non specific symptoms: | |
Tiredness | |
Fever | |
Loss of appetite | |
Upper abdominal pain | |
Arthralgia | |
Extrahepatic autoimmune disease (most common mentioned): | |
Thyroiditis | 10%-23% |
Primary biliary cirrhosis | 10%-20% |
Diabetes | 7%-9% |
Primary sclerosing cholangitis | 2%-8% |
Rheumatoid arthritis | 2%-5% |
Celiac disease | 1%-2% |
Table 3 Simplified diagnostic criteria for auto immune hepatitis[75]
Variable | Cutoff | Points |
ANA or ASMA | ≥ 1:40 | 1 |
ANA or ASMA | ≥ 1:80 | |
or LKM-1 | ≥ 1:40 | 2 |
or SLA | Positive | |
IgG | > Upper normal limit | 1 |
> 1.10 times upper normal limit | 2 | |
Liver histology (evidence of hepatitis is a necessary condition) | Compatible with AIH | 1 |
Typical AIH | 2 | |
Absence of viral hepatitis | Yes | 2 |
≥ 6: probable AIH | ||
≥ 7: definite AIH |
Table 4 Indication for treatment of auto immune hepatitis (adapted from Manns et al[4])
Absolute | Relative |
Serum AST ≥ 10 fold ULN | Symptoms (fatigue, arthralgia, jaundice) |
Serum AST ≥ 5 fold ULN and IgG level ≥ twice normal | Serum AST and/or IgG less than absolute criteria |
Bridging necrosis or multiacinar necrosis on histological examination | Interface hepatitis |
- Citation: van Gerven NM, de Boer YS, Mulder CJ, van Nieuwkerk CM, Bouma G. Auto immune hepatitis. World J Gastroenterol 2016; 22(19): 4651-4661
- URL: https://www.wjgnet.com/1007-9327/full/v22/i19/4651.htm
- DOI: https://dx.doi.org/10.3748/wjg.v22.i19.4651