https://www.ncbi.nlm.nih.gov/pubmed/30703247 Autoimmune hepatitis

Acta Paediatr. 2019 Jan 31. doi: 10.1111/apa.14730. [Epub ahead of print]
Adequacy of scoring systems in diagnosing paediatric autoimmune hepatitis: retrospective study using a control group children with Hepatitis B infection.
Niță AF1,2, Păcurar D1,2.

Abstract

AIM:
To evaluate how correct is made the diagnosis of autoimmune hepatitis (AIH) in children, comparing the adults scoring systems - the 1999 revised scoring system by International Autoimmune Hepatitis Group and the 2007 Simplified Scoring System. The inaccuracies in diagnosis have been analysed.

METHODS:
The two scoring systems have been applied for 28 children with AIH pre-treatment and 28 with Hepatitis B infection (HBV) - matched by sex and age, all diagnosed between 2010-2017 in an emergency children's hospital in Bucharest, Romania. They were retrospectively followed throughout the period assessed.

RESULTS:
AIH was present in 85.7% cases according to the 1999 revised score, respectively 57.0% as per the 2007 simplified score. The 2007 simplified score led to false negative results when AIH was associated with another autoimmune disease (p=0.009). Patients who did not undergo liver biopsy were associated with a downgraded diagnosis by the 2007 simplified score (p=0.001).

CONCLUSION:
There is a need for a scoring system tailored to children's characteristics. Two compulsory components of the future score might be liver biopsy and associated autoimmune disorders. The existing scores could be used in children with consideration, preferably both at once and together with liver biopsy for increased accuracy. This article is protected by copyright. All rights reserved.