Korean J Gastroenterol.  2023 Feb;81(2):66-71. 10.4166/kjg.2023.001.

Diagnosis of Autoimmune Hepatitis

• Kim JH

• KMID: 2539575
• DOI: http://doi.org/10.4166/kjg.2023.001

Abstract

Autoimmune hepatitis (AIH) is an immune-mediated inflammatory liver disease with an uncertain cause. The diagnosis of AIH is based on the characteristic clinical and laboratory findings (elevated liver enzyme and hypergammaglobulinemia), the presence of characteristic autoantibodies, and compatible histological abnormalities. AIH lacks a signature diagnostic marker, and the diagnosis requires the exclusion of other diseases (viral hepatitis, alcoholic liver disease, non-alcoholic steatohepatitis, drug-induced liver injury, Wilson’s disease, and hereditary hemochromatosis). Therefore, collaboration between the clinical physician, laboratory medicine experts, and pathologists is important for a diagnosis. In December 2022, the Korean Association for the Study of the Liver (KASL) clinical practice guidelines were established. This review article summarizes the diagnosis part of these guidelines.

Keyword

Hepatitis; autoimmune; Diagnosis; Guideline

Figure

• 

  Fig. 1 Diagnostic algorithm of autoimmune hepatitis. AIH, autoimmune hepatitis; ANCA, antineutrophil cytoplasmic antibody; anti-LC1, antibody to the liver cytosol type 1; anti-LKM1, antibody to the liver kidney microsome type 1; anti-SLA, antibody to soluble liver antigen; DILI, drug-induced liver injury; IgG, immunoglobulin G; SMA, smooth muscle antibody.

• 

  Fig. 2 Histopathology of autoimmune hepatitis. Microscopic features of autoimmune hepatitis. Chronic hepatitis with moderate porto-periportal activity, hepatic rosette formation, and lymphohistiocytic infiltration around the interlobular bile duct is seen (H&E stain, x400).

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