Applicability of International Autoimmune Hepatitis Group (IAIHG) Scoring System for Autoimmune Hepatitis in Pediatrics

Overview

Journal Biology (Basel)

Publisher MDPI

Specialty Biology

Date 2023 Mar 29

PMID 36979170

Authors

Vorada Sakulsaengprapha

Paul Wasuwanich

Gayathri Naraparaju

Yelena Korotkaya

Supharerk Thawillarp

Kiyoko Oshima

Christine Karwowski

Ann O Scheimann

Wikrom Karnsakul

Affiliations

Soon will be listed here.

Abstract

Introduction: Many hepatologic pathologies mimic autoimmune hepatitis (AIH). Researchers developed the International Autoimmune Hepatitis Group (IAIHG) scoring system to compensate for the lack of specific diagnostic tests for AIH. The scoring system was not designed with pediatric patients in mind, so there are limits to its pediatric use. Additionally, there is limited information on the value of a liver biopsy in conjunction with its use.

Methods: In this retrospective study, we evaluated the effect of liver biopsy scores on the IAIHG scoring system in patients that were 0-18 years old with suspected AIH. We also analyzed demographic data and laboratory values associated with a final AIH diagnosis.

Results: We found that interface hepatitis and predominant plasma cells found during the biopsy were significantly associated with a final AIH diagnosis. We also found that abnormal laboratory values were associated with an AIH diagnosis. We found that IAIHG scores calculated post-liver biopsy showed a greater area under the receiver operating characteristic curve (AUROC) of 0.95, which was compared to 0.88 for the scores calculated before a liver biopsy. Including biopsy metrics lowered the optimized cutoff score and test specificity.

Conclusion: Incorporating liver histopathological features improved the performance of the IAIHG scoring system. Further studies to identify other potential elements in liver histology may improve the performance metrics of the IAIHG test in the pediatric population.

Citing Articles

Advances in Idiosyncratic Drug-Induced Liver Injury Issues: New Clinical and Mechanistic Analysis Due to Roussel Uclaf Causality Assessment Method Use.

Teschke R, Danan G Int J Mol Sci. 2023; 24(13).

PMID: 37446036 PMC: 10341975. DOI: 10.3390/ijms241310855.

Correction: Sakulsaengprapha et al. Applicability of International Autoimmune Hepatitis Group (IAIHG) Scoring System for Autoimmune Hepatitis in Pediatrics. 2023, , 479.

Sakulsaengprapha V, Wasuwanich P, Naraparaju G, Korotkaya Y, Thawillarp S, Oshima K Biology (Basel). 2023; 12(5).

PMID: 37237572 PMC: 10215181. DOI: 10.3390/biology12050727.

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