Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm

    Disease

    Select...

    Specialty

    Select...

    Chief Complaint

    Select...

    Organ System

    Select...

    Patent Pending

    Log In

    Show
    Forgot your password?
    Log In
    Or create a new account (it's free)

    Forgot Password?

    Enter your email address and we'll send you a link to reset your password.

    Get New Password

    Sign In Required

    To save favorites, you must log in.

    Creating an account is free, easy, and takes about 60 seconds.

    Revised Original Score for Autoimmune Hepatitis (AIH)

    Revised version of the original scoring system for the diagnosis of autoimmune hepatitis.
    Favorite
    When to Use
    Why Use

    Patients with established hepatitis and available liver biopsy results, but unclear diagnosis.

    AIH is multifactorial, complex, and typically has many competing diagnoses. The score offers a data driven, consensus-based path to help guide treatment.

    Female
    +2
    Male
    0
    <1.5
    +2
    1.5-3.0
    0
    >3.0
    -2
    >2.0
    +3
    1.5-2.0
    +2
    1.0-1.5
    +1
    <1.0
    0
    >1:80
    +3
    2:20
    +2
    1:40
    +1
    <1:40
    0
    Anti-mitochondrial antibody positive
    -4
    Positive
    -3
    Negtive
    +3
    Positive
    -4
    Negtive
    +1
    25 g/day
    +2
    >60 g/day
    -2
    Interface hepatitis
    +3
    Predominantly lymphoplasmacytic infiltrate
    +1
    Rosetting of liver cells
    +1
    Biliary changes
    -3
    Other changes
    -3
    None of the above
    -5
    Other autoimmune disease(s)
    +2
    Seropositivity for other defined autoantibodies
    +2
    HLA-DR3 or HLA-DR4
    +1
    Complete
    +2
    Relapse
    +3
    About the Creator
    Dr. Fernando Alvarez

    Result:

    Please fill out required fields.

    Next Steps
    Evidence
    Creator Insights

    Advice

    AIH is a complex diagnosis partly because there is no anatomic criterion (i.e. ’gold’) standard. The revised (1999), conventional AIH score solves this problem by defining the diagnosis, though some would say the recently developed, more specific, simplified version offers a preferred alternative.

    Management

    We are unaware of validated management algorithms using the AIH score.

    Critical Actions

    Overlap with multiple conditions is always a concern to consider, despite score findings, and ‘definite’ scores are considerably more predictive than ‘probable’ scores.

    Formula

    Addition of the selected points.

    Facts & Figures

    Score interpretation:

    Interpretation of aggregate scores Score
    Pre-treatment
    Definite AIH >15
    Probable AIH 10–15
    Post-treatment
    Definite AIH >17
    Probable AIH 12–17

    Evidence Appraisal

    The conventional AIH score has been tested by numerous groups, typically in referral populations using database and chart review validations. With many complex inputs the score codifies an accepted and user friendly approach to diagnosis, but has been criticized for low specificity and thus false positives, particularly in the ‘probable AIH’ category.

    Dr. Fernando Alvarez

    About the Creator

    Fernando Alvarez, MD, is the Chief of the Division of Gastroenterology, Hepatology & Nutrition at CHU Sainte-Justine, University of Montreal. He studied medicine in his home country of Argentina, where he focused on hepatology and pediatrics. He currently practices pediatric hepatology, and he researches topics including autoimmune hepatitis, viral hepatitis, and liver immunity.

    To view Dr. Fernando Alvarez's publications, visit PubMed