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Frequency and Nature of the Variant Syndromes of Autoimmune Liver Disease

table  1.   Modified Scoring System for the Diagnosis of Autoimmune Hepatitis
Category Factor Score Category Factor Score
Sex Female +2 Alcohol <25 g/d >40 g/d 0 -2
Alk Phos:AST ratio  >= 3 <3 -2 +2 Immune disease Patient or relative +1
 gamma -Globulin or IgG levels above normal >2.0 1.5-2.0 1.0-1.5 <1.0 +3 +2 +1 0  Histological features Interface and acinar hepatitis with bridging Interface hepatitis Rosettes Plasma cells Biliary changes Other features +3 +2 +1 +1 1 -3
ANA, SMA, or anti-LKM1 titers >1:80 1:80 1:40 <1:40 +3 +2 +1 0 
AMA Positive  -2 Blood transfusion   or drugs Yes No -2 +1
Viral markers HBsAg   -3
IgM anti-HAV   -3
HCV RNA -3 Pretreatment score
Other viruses  -3   Definite diagnosis >15
Anti-HCV  -2   Probable diagnosis 10-15
All negative +3   Nondiagnostic <10
HLA DR3 or DR4 +1
Abbreviations: Alk Phos:AST ratio, ratio of serum elevations above reference value of alkaline phosphatase and aspartate transaminase; IgG, serum immunoglobulin G level; HBsAg, hepatitis B surface antigen; IgM anti-HAV, immunoglobulin M antibodies to hepatitis A virus.

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