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With Typical Autoimmune Hepatitis Labs, Biopsy Unneeded

Those with clinical features of autoimmune hepatitis likely to have compatible liver histology

FRIDAY, Jan. 28 (HealthDay News) -- Patients with clinical features of autoimmune hepatitis (AIH) are likely to have a compatible liver histology and may not need to undergo a liver biopsy, according to a study published in the January issue of Clinical Gastroenterology and Hepatology.

Einar Björnsson, M.D., from the Landspitali University Hospital in Reykjavik, Iceland, and colleagues reviewed data from 257 patients with AIH for whom clinical, biochemical, and histological data were available.

The investigators found that 71 percent of the patients tested positive for antinuclear antibodies, 45 percent had positive smooth muscle antibodies, and 11 percent were seronegative. Increased levels of autoantibodies and/or γ-globulins were found in 97 percent of patients. In 95 percent of cases, the histology was compatible with AIH. Overall, 77 percent of patients had a score of at least six, which indicated probable or definite AIH according to the most recent simplified diagnostic criteria. The researchers concluded that, in patients who meet other clinical criteria for AIH, biopsy samples may be unnecessary.

"Unless biochemical or clinical parameters are suggestive of a different liver disease, a liver biopsy is in most cases not needed to establish the diagnosis of AIH. Given the discomfort, complication rates, and costs associated with a liver biopsy, it must be questioned whether it is justified to perform a routine liver biopsy in patients with a high clinical suspicion of AIH," the authors write.

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