KASL clinical practice guidelines for management of autoimmune hepatitis 2022

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doi:10.3350/cmh.2023.0087

Cited by 5 publications

(18 citation statements)

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“…Liver biopsy is an essential component in making a diagnosis of AIH, and each AIH scoring system accordingly contains a histology score [ 6 ]. The 1999 IAIHG system emphasizes the importance of moderate/severe interface hepatitis (3 points out of a maximum of 5 histology points), and the total histology score is the result of a simple addition of component scores.…”

Section: Discussionmentioning

confidence: 99%

“…Liver biopsy is an essential part of the diagnosis of AIH, and this is reflected in the histology components of the 1999 IAIHG and 2008 IAIHG systems [ 3 , 4 , 6 ]. For example, in the 2008 IAIHG system, in which a minimum of 6 points is necessary to call a case as at least “probable” AIH, liver histology is allocated up to 2 out of a total of 8 points [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Comparison of four histological scoring systems for autoimmune hepatitis to improve diagnostic sensitivity

Ahn,

Jeong,

Cho

et al. 2023

Clin Mol Hepatol

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Background/Aims: The histological criteria in the 1999 and 2008 scoring systems proposed by the International Autoimmune Hepatitis Group (IAIHG) have their inherent limitations in diagnosing autoimmune hepatitis (AIH). In this study, we evaluated the histology components of four scoring systems (1. revised original scoring system [“1999 IAIHG”], 2. simplified scoring system [“2008 IAIHG”], 3. modified histologic criteria [“2017 UCSF”], and 4. a new histologic criteria proposed by the International AIH Pathology Group [“2022 IAHPG”]) in AIH patients.Methods: Medical records and liver biopsies were retrospectively reviewed for 68 patients from two independent medical institutions, diagnosed with AIH based on the 1999 IAIHG system between 2006 and 2016. The histological features were reviewed in detail, and the four histological scoring systems were compared.Results: Out of the 68 patients, 56 (82.4%) patients met the “probable” or “definite” AIH criteria of the 2008 IAIHG system, and the proportion of histologic score 2 (maximum) was 40/68 (58.8%). By applying the 2017 UCSF criteria, the number of histology score 2 increased to 60/68 (88.2%), and “probable” or “definite” AIH cases increased to 61/68 (89.7%). Finally, applying the 2022 IAHPG histology score resulted in the highest number of cases with histologic score 2 (64/68; 94.1%) and with a diagnosis of “probable” or “definite” AIH (62/68; 91.2%).Conclusions: The recently proposed UCSF/IAHPG histological criteria increased the histology score of AIH. Substituting the histology component of the 2008 IAIHG system with the 2022 IAHPG criteria increased the sensitivity for diagnosing AIH (≥“Probable AIH”) from 82.4% to 91.2%.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of four histological scoring systems for autoimmune hepatitis to improve diagnostic sensitivity

Ahn,

Jeong,

Cho

et al. 2023

Clin Mol Hepatol

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“…The credibility of the RID system is bolstered by requiring physician-validated diagnoses that rely on biochemical, histological, and clinical evidence [ 9 , 27 ]. For AIH, RID diagnosis depends on specific laboratory and histologic findings: (1) elevated levels of aminotransferase and immunoglobulin G; (2) presence of characteristic autoantibodies; and (3) defined histological abnormalities excluding evidence for other liver diseases [ 2 , 28 ]. Similarly, for PBC, individuals meeting at least two of the following conditions may be classified as RID beneficiaries: (1) cholestasis with alkaline phosphatase elevation without evidence of other causes; (2) presence of antimitochondrial antibody or PBC-specific antinuclear antibody immunofluorescence (sp100 or gp210); and (3) characteristic pathology with chronic, nonsuppurative cholangitis [ 3 , 29 ].…”

Section: Methodsmentioning

confidence: 99%

Epidemiology of autoimmune liver disease in Korea: evidence from a nationwide real-world database

Lim,

Kim

2024

Orphanet J Rare Dis

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Background Autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) are all immune-mediated chronic inflammatory liver diseases. Autoimmune liver diseases are rare, making identification and treatment difficult. To improve clinical outcomes and enhance patient quality of life, we performed an epidemiological study of autoimmune liver diseases based on real-world comprehensive data. Results We used National Health Insurance Service claims data in Korea from 2005 to 2019. Patients were identified using the International Classification of Disease 10th Revision code, and rare intractable disease codes assigned according to the strict diagnostic criteria. In the AIH cohort, 8,572 (83.9%) were females and the mean age at diagnosis was 56.3 ± 14.3 years. PBC also showed female dominance (83.3%) and the mean age was 57.8 ± 12.6 years. Patients with PSC showed no sex predominance and had a mean age of 57.8 ± 21.5 years. During the study period, there were 10,212, 6,784, and 888 AIH, PBC, and PSC patients, respectively. The prevalence of AIH, PBC, and PSC in 2019 were 18.4, 11.8, and 1.5 per 100,000 population, while the corresponding incidences were 2.3, 1.4, and 0.3 per 100,000 population, respectively. Analysis of sex-age-standardized data showed that the annual prevalence of these diseases is increasing. The 10-year survival rates were 89.8%, 74.9%, and 73.4% for AIH, PBC, and PSC, respectively. Conclusions The number of patients with autoimmune liver disease in South Korea is increasing over time. Further research on autoimmune liver disease is needed to fulfill unmet clinical needs.

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“…Among diseases of internal organs, liver diseases are becoming more and more common and require a mul-tidisciplinary approach to the management of patients. Autoimmune hepatitis (AIH) is an inflammatory liver disease that has autoimmune mechanisms of development and unknown etiology [3]. In addition, AIH affects patients of any age, gender, and ethnic group, but women are affected 6 times more often and have certain geographical features [4,5].…”

Section: Connection Of the Publication With Planned Research Workmentioning

confidence: 99%