Differenciation Between Clinical And Histoligical Characteristics Of Autoimmune Hepatitis And Drug-induced Liver Injury:a Retrospective Study

Aims: Identification of specific characteristics to Autoimmune Hepatitis and DrugInduced Liver Injury to provide a better clinical diagnosis.Methods: Of 275 consecutive patients with liver biopsy from January 2015 to July 2017 in the Second hospital of Nanjing.55 patients were diagnosed as DILI or AIH(24DILI and 31AIH)based on their clinical,serological,and histologic findings.Results: Laboratory tests showed that AIH presented a higher median value of AST [132IU/L(57.8-320.5)vs 56.7 IU/L(32-137.6)],ADA [17.5IU/L(13.4-26.6)vs 12.8IU/L(7.6-19.9)],Ig G[17.5g/L(12.6-20.7)vs13.5g/L(10.89-15.5)],in contrast,ALB was high in DILI patient[42.1g/L(36.62-44.8)vs.37g/L(32.8-40.8)],interestingly serological test result did not show statistical significance(p>0.05).Furthermore,histological analysis revealed 41.92% of AIH biopsy presented typical picture of AIH including a predominance of interface hepatitis,lymphoplasmocytic infiltrates,Rosette formation,Emperipolesis,(93.55%,70.97%,61.29%51.61% respectively).In contrary DILI presented only 4.17% the typical histology of AIH.Conclusions: The study demonstrated that after excluding all other suspicious diseases that can cause liver injuries,it still remains difficult to rely only on clinical,serological,immunological even on scoring method to make accurate differentiation between AIH and DILI;however,liver biopsy appeared to bring a tremendous help in distinguishing the two conditions.