| Autoimmune
Hepatitis: Scoring System (Johnson
et al., 1993) |
| Feature |
-3 |
-2 |
-1 |
0 |
+1 |
+2 |
+3 |
| Sex |
|
|
|
Male |
|
Female |
|
| Other autoimmune disease (patient or first-degree relative) |
|
|
|
Absent |
Present |
|
|
| Blood transfusion or drugs |
|
Yes |
|
|
No |
|
|
| Alcohol (male) |
|
80 gm/day |
50-80 gm/day |
35-50 gm/day |
|
<35 gm/day |
|
| Alcohol (female) |
|
60 gm/day |
40-60 gm/day |
25-40 gm/day |
|
<25 gm/day |
|
| IgM anti HAV |
Present |
|
|
Absent |
|
|
|
| HBsAg or IgM anti HBc |
Present |
|
|
Absent |
|
|
|
| HCV RNA |
Present |
|
|
Absent |
|
|
|
| Anti-HCV and/or RIBA |
|
Present |
|
Absent |
|
|
|
| Other viral markers |
Present |
|
|
Absent |
|
|
|
| No viral markers |
|
|
|
|
|
|
No viral markers |
| HLA B8 DR3 or DR4 |
|
|
|
Absent |
Present |
|
|
| IgG, gamma glob, or globulin |
|
|
|
<1x normal |
1-1.5x normal |
1.5-2x normal |
2x+ normal |
| Alk phos:ALT |
|
3 |
|
|
|
|
|
| ANA, SMA, or LKM1 (adults) |
|
|
|
<1:40 |
1:40 |
1:80 |
1:80 |
| ANA or LKM1 (children) |
|
|
|
<1:10 |
|
1:10-20 |
1:20 |
| SMA (children) |
|
|
|
<1:20 |
|
1:20 |
1:20 |
| Other markers |
|
|
|
|
|
Present |
|
| AMA |
|
Present |
|
Absent |
|
|
|
| Histology |
Incompatible bile duct changes |
|
Mild bile duct changes |
|
Frequent plasma cells, rosettes (1 each) |
Bridging necrosis |
Piecemeal necrosis, lobular hepatitis, and
bridging necrosis |
| Response to therapy |
|
No response |
|
Partial response or failure |
|
Complete response |
Relapse |
|
|
|
|
|
|
|
|
|
Interpretation of scores: An aggregate score greater than 15 prior to therapy constitutes
a definite diagnosis of AIH. A score of 10-15 is interpreted as probable AIH. A score greater than 17 following therapy is considered positive,
and a score of 12-17 after therapy is considered probable, for the diagnosis of AIH.
|
