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Overview of clinical presentation and diagnosis of autoimmune hepatitis in a single, referral center

Denitsa Dukova, Iskren Kotzev


BACKGROUND AND AIMS: The diagnosis of autoimmune hepatitis (AIH) is often difficult because of the large heterogeneity of its clinical, laboratory and histological features and the absence of a specific diagnostic test. This study aims to determine the demographic, clinical, biochemical and serological characteristics and histological findings of AIH and to what extent they correspond to the International Autoimmune Hepatitis Group (IAIHG) diagnostic criteria.

METHODS: Retrospective analysis of the adult patients diagnosed as AIH at our clinic from January 2005 to December 2013 was performed. Demographic, laboratory, clinical and histological data of the patients were collected and a score was calculated for each patient based on the IAIHG revised and simplified scoring system. Only pretreatment scores were analyzed.

RESULTS: 57 patients were diagnosed as AIH on clinical grounds (mean age: 50 years, range: 19-74), from which 82.5% were women. 49.1% were asymptomatic, 10.5% had acute hepatitis, and 40.3% had chronic liver disease. The most common symptoms at presentation were fatigue (24.6%), icterus (21.1%) and dark urine (19.3%). 28.1% of patients had cirrhosis at presentation. Elevated IgG levels were detected in 75% of cases. ANA, ASMA, ALKM and pANCA were positive in 75.0%, 54.5%, 6.5% and 25.0% of patients respectively. Liver biopsy was performed in 42.1% of the patients. 84% of patients diagnosed with AIH according to clinical judgment of the treating physician were also diagnosed with AIH according to the revised and simplified criteria.

CONCLUSIONS: The majority of patients satisfy the original or simplified criteria and these criteria are
useful in the diagnosis.


autoimmune hepatitis; scoring systems; diagnosis; clinical presentation; laboratory features

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About The Authors

Denitsa Dukova
Saint Marina university hospital of Varna

Clinic of hepatogastroenterology

Iskren Kotzev
Medical university of Varna

Clinic of hepatogastroenterology

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