Performance of the international classifications criteria for autoimmune hepatitis diagnosis in Mexican patients.

Autoimmunity

PubMedID: 21875376

Muñoz-Espinosa L, Alarcon G, Mercado-Moreira A, Cordero P, Caballero E, Avalos V, Villarreal G, Senties K, Puente D, Soto J, Esqueda B, Campos G, Martínez M, Jaquez J, Ramirez A, Reyes I, Kershenobich D, Montano-Loza AJ. Performance of the international classifications criteria for autoimmune hepatitis diagnosis in Mexican patients. Autoimmunity. 2011;44(7):543-8.
The revised score of the International Autoimmune Hepatitis Group (R-IAIHG) and the simplified criteria (SC) are used for diagnosis of autoimmune hepatitis (AIH). Our aim is to evaluate the performance of these classifications to differentiate AIH from other autoimmune liver diseases. The frequency of diagnosis of definite AIH was similar both by the R-IAIHG and the SC systems (41% versus 40%), whereas diagnosis of probable AIH was made more commonly by the R-IAIHG than the SC (59% versus 29%), and 23 patients that have been graded as definite (n = 7) or probable (n = 16) AIH by the R-IAIHG had non-diagnostic scores by the SC system. The scoring systems rendered concordant diagnosis of definite (n = 15) and probable (n = 13) AIH in 28/73 patients (38%). Discordant diagnoses of AIH were rendered in 45/73 patients (62%). The R-IAIHG exhibited a sensitivity of 95%, specificity of 90%, and positive predictive value (PPV) and negative predictive value (NPV) of 93% for both. On the other hand, the SC had a lower sensitivity (65%) but a higher specificity (100%), PPV of 100%, and NPV of 68%. In conclusion, both international scoring systems diagnosed the same number of cases as definite AIH. The R-IAIHG showed a higher sensitivity in diagnosing AIH, whereas the SC showed a higher specificity. SC are easier to apply at the bedside and exclude more patients that could have a different etiology.