Autoimmune Hepatitis Diagnostic Criteria

 
Sex

Female (2 points)

Male (0 points)
Alkaline phosphatase / aminotransferase ratio

>3.0 (-2 points)

<3.0 (2 points)
Ratio of serum globulin, gamma globulin or IgG to corresponding normal

>2.0 (3 points)

1.5 - 2.0 (2 points)

1.0 - 1.5 (1 point)

<1.0 (0 points)
Autoantibodies (titres by immunofluorescence on rodent tissues)

ANA or LKM-1 >1:80 (>1:20 child) (3 points)

ANA or LKM-1 1:80 (1:10 - 1:20 child) (2 points)

ANA or LKM-1 1:40 (1 point)

ANA or LKM-1 <1:40 (<1:10 child) (0 points)

SMA >1:80 (>1:20 in child) (3 points)

SMA 1:80 (1:20 child) (2 points)

SMA 1:40 (1 point)

SMA <1:40 (<1:20 child) (0 points)

Positive SLA, ASGP-R, LSP, LC1, LP, HHPM or sulfatide (2 points)

Positive antimitochondrial antibody (-2 points)
Viral markers

IgM anti-HAV, HBsAg or IgM anti HBc (-3 points)

Anti-HCV by ELISA or RIBA (-2 points)

Anti-HCV by PCR / RNA (-3 points)

Other test or active viral infection (-3 points)

Sero negative for virii (3 points)
History of recent hepatotoxic drug exposure or parenteral exposure to blood products

Yes (-2 points)

No (1 point)
Alcohol consumption

Male <35 gm/day; female <25 gm/day (2 points)

Male 35-35 gm/day; female 25-40 gm/day (0 points)

Male 50-80 gm/day; female 40-60 gm/day (-2 points)

Male >80 gm/day; female >60 gm/day (-1 point)
Genetic factors

Other autoimmune diseases in patient or first-degree relatives (1 point)

HLA B8-DR3 haplotype or DR4 allotype (1 point)
Histology

CAH / piecemeal necrosis / lobular involvement / bridging necrosis (3 points)

Same without lobular involvement or bridging (2 points)

Rosetting (1 point)

Marked plasma cell infiltrate (1 point)

Biliary changes (-1 point)

Granuloma / siderosis / copper / other changes suggestive of a different etiology (-3 points)
Response to therapy

Complete response (2 points)

Partial response or failure (0 points)

No response in terms of disease activity (-2 points)

Relapse during or after treatment withdrawl after complete initial response (3 points)

 
Total Criteria Point Count:
 

 

Pre-treatment AIH prediction

 
16 to 25 Points: Definite Autoimmune Hepatitis
10 to 15 Points: Probable AIH
0 to 9 Points: Less likely AIH

 

 

Post-treatment AIH prediction

 
18 to 25 Points: Definite Autoimmune Hepatitis
12 to 17 Points: Probable AIH
0 to 11 Points: Less likely AIH

 

 
References
  1. Johnson PJ, MacFarland IG. Meeting report: International autoimmune hepatitis group. Hepatology. 1993;18:998-1005. PubMed ID: 8406375 PubMed Logo

 

 
 

 
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