Evaluation of Validity and Efficiency of Diagnostic Criteria in Autoimmune Hepatitis in Children
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Abstract
Background: Autoimmune hepatitis (AIH) is a progressive inflammatory liver disease with various clinical symptoms, but treatment and
prevention of hepatic failure and cirrhosis is possible with early diagnosis. However, no specific test has been approved for the diagnosis
of AIH. In 2008, the International Autoimmune Hepatitis Group (IAIHG) developed a simplified diagnostic scoring system that has been
widely used in practice. Nevertheless, it cannot distinguish AIH from Primary Sclerosing Cholangitis (PSC) and consensus is lacking with
respect to its validity, sensitivity, and applicability for children patients. The newer 2018 version also requires validation. The present
study intends to evaluate the validity and efficiency of the IAIHG simplified scoring system and new scoring system in children with AIH.
Methods: The present study is a non-interventional case–control study covering 152 patients with hepatic diseases (83 patients with
AIH and 69 patients with Wilson disease (WD)). Titers of autoantibodies, IgG levels, hepatic histology, and absence of viral hepatitis were
scored and calculated according to IAIHG diagnostic criteria. Statistics software package (SPSS) and draft receiver operating characteristic
(ROC) curves was used to analyze data and determine value of diagnostic criteria.
Result: In our study, both scoring systems’ accuracy was good in AIH diagnosis, although new score displays higher sensitivity and specificity,
suggestive of greater accuracy and predictive strength.
Conclusion: Our study is the first validation study of the new scoring system in diagnosing AIH, and further studies require verifying this
scoring system.
prevention of hepatic failure and cirrhosis is possible with early diagnosis. However, no specific test has been approved for the diagnosis
of AIH. In 2008, the International Autoimmune Hepatitis Group (IAIHG) developed a simplified diagnostic scoring system that has been
widely used in practice. Nevertheless, it cannot distinguish AIH from Primary Sclerosing Cholangitis (PSC) and consensus is lacking with
respect to its validity, sensitivity, and applicability for children patients. The newer 2018 version also requires validation. The present
study intends to evaluate the validity and efficiency of the IAIHG simplified scoring system and new scoring system in children with AIH.
Methods: The present study is a non-interventional case–control study covering 152 patients with hepatic diseases (83 patients with
AIH and 69 patients with Wilson disease (WD)). Titers of autoantibodies, IgG levels, hepatic histology, and absence of viral hepatitis were
scored and calculated according to IAIHG diagnostic criteria. Statistics software package (SPSS) and draft receiver operating characteristic
(ROC) curves was used to analyze data and determine value of diagnostic criteria.
Result: In our study, both scoring systems’ accuracy was good in AIH diagnosis, although new score displays higher sensitivity and specificity,
suggestive of greater accuracy and predictive strength.
Conclusion: Our study is the first validation study of the new scoring system in diagnosing AIH, and further studies require verifying this
scoring system.