Consensus recommendations for histological criteria of autoimmune hepatitis from the International AIH Pathology Group
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Consensus recommendations for histological criteria of autoimmune hepatitis from the International AIH Pathology Group : Results of a workshop on AIH histology hosted by the European Reference Network on Hepatological Diseases and the European Society of Pathology. / Lohse, Ansgar W; Sebode, Marcial; Bhathal, Prithi S; Clouston, Andrew D; Dienes, Hans P; Jain, Dhanpat; Gouw, Annette S H; Guindi, Maha; Kakar, Sanjay; Kleiner, David E; Krech, Till; Lackner, Carolin; Longerich, Thomas; Saxena, Romil; Terracciano, Luigi; Washington, Kay; Weidemann, Sören; Hübscher, Stefan G; Tiniakos, Dina.
in: LIVER INT, Jahrgang 42, Nr. 5, 05.2022, S. 1058-1069.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Consensus recommendations for histological criteria of autoimmune hepatitis from the International AIH Pathology Group
T2 - Results of a workshop on AIH histology hosted by the European Reference Network on Hepatological Diseases and the European Society of Pathology
AU - Lohse, Ansgar W
AU - Sebode, Marcial
AU - Bhathal, Prithi S
AU - Clouston, Andrew D
AU - Dienes, Hans P
AU - Jain, Dhanpat
AU - Gouw, Annette S H
AU - Guindi, Maha
AU - Kakar, Sanjay
AU - Kleiner, David E
AU - Krech, Till
AU - Lackner, Carolin
AU - Longerich, Thomas
AU - Saxena, Romil
AU - Terracciano, Luigi
AU - Washington, Kay
AU - Weidemann, Sören
AU - Hübscher, Stefan G
AU - Tiniakos, Dina
N1 - © 2022 The Authors. Liver International published by John Wiley & Sons Ltd.
PY - 2022/5
Y1 - 2022/5
N2 - BACKGROUND & AIMS: Diagnostic histological criteria for autoimmune hepatitis (AIH) have not been clearly established. Previously published criteria focused mainly on chronic AIH, in which inflammatory changes mainly occur in portal/periportal regions and may not be applicable to acute presentation of AIH, in which inflammatory changes are typically predominantly lobular in location. International consensus criteria for the diagnosis and assessment of disease severity in both acute and chronic AIH are thus urgently needed.METHODS: Seventeen expert liver pathologists convened at an international workshop and subsequently used a modified Delphi panel approach to establish consensus criteria for the histopathological diagnosis of AIH.RESULTS: The consensus view is that liver biopsy should remain standard for diagnosing AIH. AIH is considered likely, if there is a predominantly portal lymphoplasmacytic hepatitis with more than mild interface activity and/or more than mild lobular hepatitis in the absence of histological features suggestive of another liver disease. AIH is also considered likely if there is predominantly lobular hepatitis with or without centrilobular necroinflammation and at least one of the following features: portal lymphoplasmacytic hepatitis, interface hepatitis or portal-based fibrosis, in the absence of histological features suggestive of another liver disease. Emperipolesis and hepatocellular rosettes are not regarded as being specific for AIH.CONCLUSIONS: The criteria proposed in this consensus statement provide a uniform approach to the histological diagnosis of AIH, which is relevant for patients with an acute as well as a chronic presentation and to more accurately reflect the current understanding of liver pathology in AIH.
AB - BACKGROUND & AIMS: Diagnostic histological criteria for autoimmune hepatitis (AIH) have not been clearly established. Previously published criteria focused mainly on chronic AIH, in which inflammatory changes mainly occur in portal/periportal regions and may not be applicable to acute presentation of AIH, in which inflammatory changes are typically predominantly lobular in location. International consensus criteria for the diagnosis and assessment of disease severity in both acute and chronic AIH are thus urgently needed.METHODS: Seventeen expert liver pathologists convened at an international workshop and subsequently used a modified Delphi panel approach to establish consensus criteria for the histopathological diagnosis of AIH.RESULTS: The consensus view is that liver biopsy should remain standard for diagnosing AIH. AIH is considered likely, if there is a predominantly portal lymphoplasmacytic hepatitis with more than mild interface activity and/or more than mild lobular hepatitis in the absence of histological features suggestive of another liver disease. AIH is also considered likely if there is predominantly lobular hepatitis with or without centrilobular necroinflammation and at least one of the following features: portal lymphoplasmacytic hepatitis, interface hepatitis or portal-based fibrosis, in the absence of histological features suggestive of another liver disease. Emperipolesis and hepatocellular rosettes are not regarded as being specific for AIH.CONCLUSIONS: The criteria proposed in this consensus statement provide a uniform approach to the histological diagnosis of AIH, which is relevant for patients with an acute as well as a chronic presentation and to more accurately reflect the current understanding of liver pathology in AIH.
KW - Biopsy
KW - Hepatitis, Autoimmune
KW - Humans
KW - Liver/pathology
KW - Severity of Illness Index
U2 - 10.1111/liv.15217
DO - 10.1111/liv.15217
M3 - SCORING: Journal article
C2 - 35230735
VL - 42
SP - 1058
EP - 1069
JO - LIVER INT
JF - LIVER INT
SN - 1478-3223
IS - 5
ER -
