Acute onset seronegative autoimmune hepatitis

Yılmaz, Bülent; Ünlü, Ozan; Evcen, Recep; Uğurluoğlu, Ceyhan

doi:10.1097/meg.0000000000000580

Cited by 6 publications

(2 citation statements)

References 5 publications

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“…An acute case of seronegative AIH like our case was reported by Yilmaz et al, which had a calculated SDC score of 4, which was not sufficient to make the diagnosis. Diagnosis of probable AIH was made in their case per pretreatment RDC score of 14 [11]. SDC and RDC have very similar diagnostic accuracies for patients with typical features of AIH.…”

Section: Discussionmentioning

confidence: 99%

Seronegative Autoimmune Hepatitis A Clinically Challenging Difficult Diagnosis

Sherigar

Yavgeniy

Guss

et al. 2017

Case Reports in Medicine

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Autoimmune hepatitis (AIH) is a complex liver disease of unknown cause which results in immune-mediated liver injury with varied clinical presentations. Seronegative AIH follows a similar course to autoantibody-positive disease and diagnosis may be challenging. There are no single serologic tests of sufficient diagnostic specificity, and delay in appropriate treatment may lead to progression of the liver disease and liver failure. The revised conventional diagnostic criteria (RDC) scoring for AIH is complex and not routinely used in the clinical practice. The more recent simplified diagnostic criteria (SDC) scoring proposed by International Autoimmune Hepatitis Group in 2008 has wider application in routine practice facilitating the diagnosis of AIH with a specificity and sensitivity of ~90%. In this report, we describe a case of seronegative autoimmune hepatitis diagnosed using RDC. SDC score calculated in our case was 4 and was not diagnostic for AIH. We subsequently used the complex revised diagnostic criteria for definitive diagnosis. Some of the patients previously diagnosed as cryptogenic active hepatitis of unknown etiology probably had an unrecognized diagnosis of seronegative autoimmune hepatitis. SDC scoring may not be applicable in patients with seronegative autoimmune hepatitis. These patients should be reassessed by using RDC.

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Section: Discussionmentioning

confidence: 99%

Seronegative Autoimmune Hepatitis A Clinically Challenging Difficult Diagnosis

Sherigar

Yavgeniy

Guss

et al. 2017

Case Reports in Medicine

View full text Add to dashboard Cite

show abstract

“…Although antibodies to soluble liver antigen/liver-pancreas (anti-SLA/LP) are highly specific markers for AIH in both AIH-1 and AIH-2 [ 153 , 154 ], none was positive for anti-SLA in 154 Japanese patients with type 1 AIH, anti-SLA/LP positivity seems to be unusual in APASL group [ 155 ]. The presence of an autoantibody is a common feature of AIH, in acute-onset AIH or corticosteroid-treated AIH, autoantibodies can be absent or loss [ 156 , 157 ]. It was reported that in Japan, ANA negative or less than 1:40 were seen in 29% of severe or fulminant AIH, and 39% of acute-onset AIH patients [ 102 , 142 ].…”

Section: Diagnosismentioning

confidence: 99%