scholarly journals Autoimmune Hepatitis: Clinical Manifestations and Diagnostic Criteria

2001 ◽  
Vol 15 (2) ◽  
pp. 107-113 ◽  
Author(s):  
Ian G Mcfarlane
Keyword(s):  
Liver Disease ◽  
Autoimmune Hepatitis ◽  
Scoring System ◽  
Clinical Manifestations ◽  
Chronic Viral Hepatitis ◽  
Published Data ◽  
Group A ◽  
Diagnostic Modalities ◽  
Circulating Autoantibodies ◽  
International Autoimmune Hepatitis Group

In 1998, the International Autoimmune Hepatitis Group - a panel of 40 hepatologists and hepatopathologists from 17 countries who have a particular interest in autoimmune hepatitis (AIH) - undertook a review, in light of subsequent experience, of the descriptive criteria and diagnostic scoring system that it had proposed in 1993 for the diagnosis of AIH. This review (published in 1999) noted that the original descriptive criteria appeared to be quite robust and required only relatively minor modifications to bring them up to date with developments and experience in diagnostic modalities for liver disease in general. Analysis of published data on the application of the original criteria in nearly 1000 patients revealed that the diagnostic scoring system had an overall diagnostic accuracy of 89.8%, with a sensitivity of 98.0%. Specificity for excluding definite AIH in patients with chronic viral hepatitis and circulating autoantibodies or patients with overlapping cholestatic syndromes was 98% to 100%, but specificity for excluding probable AIH in these disorders ranged from only 60% to 80%. Modifications, including adjustments to the weightings against biochemical and histological cholestatic features, have been made to the scoring system to improve its specificity.

scholarly journals Autoimmune Hepatitis: Serum Autoantibodies in Clinical Practice

2021 ◽  
Author(s):  
Benedetta Terziroli Beretta-Piccoli ◽  
Giorgina Mieli-Vergani ◽  
Diego Vergani
Keyword(s):  
Autoimmune Hepatitis ◽  
Current Knowledge ◽  
Reference Method ◽  
Smooth Muscle Antibody ◽  
Autoimmune Sclerosing Cholangitis ◽  
Specific Autoantibody ◽  
Circulating Autoantibodies ◽  
International Autoimmune Hepatitis Group

AbstractCirculating autoantibodies are a key diagnostic tool in autoimmune hepatitis (AIH), being positive in 95% of the cases if tested according to dedicated guidelines issued by the International Autoimmune Hepatitis Group. They also allow the distinction between type 1 AIH, characterized by positive anti-nuclear and/or anti-smooth muscle antibody, and type 2 AIH, characterized by positive anti-liver kidney microsomal type 1 and/or anti-liver cytosol type 1 antibody. Anti-soluble liver antigen is the only AIH-specific autoantibody, and is found in 20–30% of both type 1 and type 2 AIH. Anti-neutrophil cytoplasmic antibody is frequently positive in type 1 AIH, being associated also with inflammatory bowel disease and with primary/autoimmune sclerosing cholangitis. The reference method for autoantibody testing remains indirect immunofluorescence on triple tissue (rodent liver, kidney and stomach), allowing both the detection of the majority of liver-relevant reactivities, including those autoantibodies whose molecular target antigens are unknown. Of note, the current knowledge of the clinical significance of autoantibodies relies on studies based on this technique. However, immunofluorescence requires trained laboratory personnel, is observer-dependent, and lacks standardization, leading to ongoing attempts at replacing this method with automated assays, the sensitivity, and specificity of which, however, require further studies before they can be used as a reliable alternative to immunofluorescence; currently, they may be used as complementary to immunofluorescence.

Is the revised international autoimmune hepatitis group (IAHG) scoring system useful?

2001 ◽  
Vol 34 ◽  
pp. 208
Author(s):  
M. Baragiotta ◽  
W. Craig ◽  
O. James ◽  
H. Mitchison ◽  
D. Burke ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Scoring System ◽  
International Autoimmune Hepatitis Group

scholarly journals Toxoplasmosis and liver disease: literature review and clinical observation

2021 ◽  
Vol 13 (2) ◽  
pp. 135-141
Author(s):  
V. A. Greshnyakova ◽  
L. G. Gorjacheva
Keyword(s):  
Liver Disease ◽  
Liver Diseases ◽  
Clinical Observation ◽  
Clinical Manifestations ◽  
Intrauterine Infection ◽  
Chronic Viral Hepatitis ◽  
Immune Systems ◽  
Viral Hepatitis C ◽  
Almost All ◽  
Chronic Viral Hepatitis C

Toxoplasmosis is a widespread ubiquatorial disease. A distinctive feature of this parasitosis is the predominance of latent forms. As a rule, in people with intact immune systems, the disease is asymptomatic. Severe cases of toxoplasmosis are usually associated with immunodeficiencies. At the same time, in cases of a manifest course in immunocompetent persons, toxoplasmosis is characterized by a polymorphism of clinical manifestations with damage to almost all organs and systems. In addition to the widely reported lesions of the eyes, brain, and intrauterine infection (IUI) associated with T. gondii, there are reports of damage to the liver, heart, lungs, and even multisystem cases of visceral toxoplasmosis. The article describes a clinical observation of toxoplasma hepatitis in a child with chronic viral hepatitis C. This clinical observation demonstrates the possibility of liver damage in the structure of toxoplasmosis and confirms the significance of this parasitosis among the population of patients with liver diseases.

Impact of International Autoimmune Hepatitis Group scoring system in definition of autoimmune hepatitis

1996 ◽  
Vol 41 (1) ◽  
pp. 166-171 ◽  
Author(s):  
Francesco B. Bianchi ◽  
Fabio Cassani ◽  
Marco Lenzi ◽  
Giorgio Ballardini ◽  
Luigi Muratori ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Scoring System ◽  
International Autoimmune Hepatitis Group ◽  
Definition Of

Non-alcoholic steatohepatitis or autoimmune hepatitis? Sometimes a closer look under the surface is needed

2020 ◽  
Vol 13 (12) ◽  
pp. e238400
Author(s):  
Georgios N Dalekos ◽  
Nikolaos K Gatselis ◽  
George K Koukoulis
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Autoimmune Hepatitis ◽  
Chronic Liver Disease ◽  
Rare Disease ◽  
Fatty Liver Disease ◽  
Alcoholic Fatty Liver ◽  
Female Predominance ◽  
Circulating Autoantibodies ◽  
Alcoholic Fatty Liver Disease

Non-alcoholic fatty liver disease (NAFLD) is nowadays the most common liver disease worldwide. Autoimmune hepatitis (AIH) is a relatively rare disease of the liver characterised by female predominance, circulating autoantibodies, polyclonal hypergammaglobulinaemia, interface hepatitis on histology and favourable response to immunosuppression. The possibility of an additional AIH diagnosis in patients with NAFLD (NAFLD/AIH concurrence) or the presence of AIH alone instead of a supposed NAFLD diagnosis represents a challenge for clinicians. We report herein two adult patients (a 33-year-old woman and a 59-year-old man) with a previous NAFLD diagnosis who proved finally to suffer from AIH alone. These two representative cases indicate how difficult and complicated could be sometimes the diagnosis of patients with AIH highlighting the range of disease manifestations and severity while they also underline that although NAFLD is by far the most frequent chronic liver disease this could not be always the case.

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