Clinical Diagnosis of Autoimmune Hepatitis
- Onset of jaundice within prior 8 weeks
- Ongoing consumption of (female) or 60 (male) g alcohol/day for 26 months, with days of abstinence before the onset of jaundice
- AST >50, AST/ALT >1.5, and both values <400
- Serum total bilirubin >3.0 mg/dL
Potential confounding factors
- Possible ischemic hepatitis (e.g., severe upper gastrointestinal bleed, hypotension, or cocaine use within 7 days) or metabolic liver disease (Wilson disease, alpha 1 antitrypsin deficiency)
- Possible drug-induced liver disease (suspect drug within 30 days of onset of jaundice)
- Uncertain alcohol use assessment (e.g., patient denies excessive alcohol use)
- Presence of atypical laboratory tests (e.g., AST or >400 IU/L, AST/ALT <1.5), ANA >1:160 or SMA >1:80
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