{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T18:32:03Z","timestamp":1763058723570,"version":"3.44.0"},"reference-count":44,"publisher":"BMJ","issue":"e1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Frontline Gastroenterol"],"accepted":{"date-parts":[[2022,5,22]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>Diagnosis of AIH is based on a combination of clinical, laboratory and histological information. It has been formalised by diagnostic scoring systems, to which liver biopsy contributes substantially. Diagnostic biopsy is thus, desirable in nearly all patients. An adequate biopsy size, provision by clinicians of adequate information to histopathologists and active discussion at regular meetings are all important for accurate histological diagnosis. Recently, the specificity of some features previously thought to suggest AIH has been questioned, and new recommendations for histological diagnosis have been proposed, although not yet validated. The histology of acutely presenting AIH and that of severe or fulminant AIH include some characteristic features. Primary biliary cholangitis, primary sclerosing cholangitis and non-alcoholic fatty liver disease may co-exist with AIH on biopsy. Liver biopsy also enables grading of severity of inflammation and staging of fibrosis. Presence of cirrhosis is a poor prognostic marker. Repeat liver biopsy after achieving biochemical remission, although not performed routinely, enables assessment of (a) histological remission, a favourable prognostic indicator and (b) fibrosis progression. It can thus help determine further management.<\/jats:p>","DOI":"10.1136\/flgastro-2022-102192","type":"journal-article","created":{"date-parts":[[2022,6,9]],"date-time":"2022-06-09T13:21:40Z","timestamp":1654780900000},"page":"e94-e101","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Histopathologist and clinician interface in diagnosis and management of autoimmune hepatitis"],"prefix":"10.1136","volume":"13","author":[{"given":"Sarah","family":"Flatley","sequence":"first","affiliation":[{"name":"Liver Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Asha K","family":"Dube","sequence":"additional","affiliation":[{"name":"Department of Histopathology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8714-2367","authenticated-orcid":false,"given":"Dermot","family":"Gleeson","sequence":"additional","affiliation":[{"name":"Liver Unit, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,6,9]]},"reference":[{"key":"2025090708493067000_13.e1.e94.1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2010.235259"},{"key":"2025090708493067000_13.e1.e94.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.06.030"},{"key":"2025090708493067000_13.e1.e94.3","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31065"},{"key":"2025090708493067000_13.e1.e94.4","article-title":"Extrahepatic autoimmune diseases in patients with autoimmune hepatitis and their relatives: a Danish nationwide family cohort study","volume":"68","author":"Gr\u00f8nb\u00e6k","year":"2018","journal-title":"J Hepatol"},{"key":"2025090708493067000_13.e1.e94.5","doi-asserted-by":"publisher","DOI":"10.1111\/liv.13963"},{"key":"2025090708493067000_13.e1.e94.6","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14480"},{"key":"2025090708493067000_13.e1.e94.7","doi-asserted-by":"crossref","first-page":"873","DOI":"10.1016\/j.jhep.2018.05.035","article-title":"Family occurrence of autoimmune hepatitis: a Danish nationwide registry-based cohort study","volume":"69","author":"Gr\u00f8nb\u00e6k","year":"2018","journal-title":"J Hepatol"},{"key":"2025090708493067000_13.e1.e94.8","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.04.022"},{"key":"2025090708493067000_13.e1.e94.9","doi-asserted-by":"crossref","DOI":"10.1002\/hep.23588","article-title":"Drug-Induced autoimmune hepatitis: clinical characteristics and prognosis","volume":"51","author":"Bj\u00f6rnsson","year":"2010","journal-title":"Hepatology"},{"key":"2025090708493067000_13.e1.e94.10","doi-asserted-by":"publisher","DOI":"10.1055\/s-0034-1375959"},{"key":"2025090708493067000_13.e1.e94.11","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2016-204271"},{"key":"2025090708493067000_13.e1.e94.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.07.016"},{"key":"2025090708493067000_13.e1.e94.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.30444.x"},{"key":"2025090708493067000_13.e1.e94.14","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80297-9"},{"key":"2025090708493067000_13.e1.e94.15","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22322"},{"key":"2025090708493067000_13.e1.e94.16","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24481"},{"key":"2025090708493067000_13.e1.e94.17","doi-asserted-by":"publisher","DOI":"10.1111\/his.12558"},{"key":"2025090708493067000_13.e1.e94.18","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2016.267"},{"key":"2025090708493067000_13.e1.e94.19","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.humpath.2018.07.014","article-title":"Histologic features of autoimmune hepatitis: a critical appraisal","volume":"82","author":"Gurung","year":"2018","journal-title":"Hum Pathol"},{"key":"2025090708493067000_13.e1.e94.20","doi-asserted-by":"crossref","first-page":"1058-1069","DOI":"10.1111\/liv.15217","article-title":"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: results of a workshop on AIH histology hosted by the European reference network on Hepatological diseases and the European Society of pathology","volume":"42","author":"Lohse","year":"2022","journal-title":"Liver Int"},{"key":"2025090708493067000_13.e1.e94.21","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.mpdhp.2014.01.009","article-title":"Role of liver biopsy in autoimmune liver disease","volume":"20","author":"H\u00fcbscher","year":"2014","journal-title":"Diagn Histopathol"},{"key":"2025090708493067000_13.e1.e94.22","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-315259"},{"key":"2025090708493067000_13.e1.e94.23","doi-asserted-by":"crossref","unstructured":"Burak KW , Angulo P , Lindor KD . Is there a role for liver biopsy in primary sclerosing cholangitis?. 2003;98:1155\u20138.doi:10.1111\/j.1572-0241.2003.07401.x","DOI":"10.1111\/j.1572-0241.2003.07401.x"},{"key":"2025090708493067000_13.e1.e94.24","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2018-317993"},{"key":"2025090708493067000_13.e1.e94.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.11.007"},{"key":"2025090708493067000_13.e1.e94.26","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2015.11.004"},{"key":"2025090708493067000_13.e1.e94.27","unstructured":"Salmon C , Hoeroldt B , Dube A . Hepatic steatosis in patients with autoimmune hepatitis (AIH) - Prevalence, progression and possible significance. Conference:45th Annual Meeting of the European Association for the Study of the Liver (EASL), International Liver Congress 2010. Vienna Austria. Conference Publication: (var.pagings). 2052 (SUPPL. 2011). J Hepatol."},{"key":"2025090708493067000_13.e1.e94.28","doi-asserted-by":"crossref","first-page":"S584","DOI":"10.14309\/01.ajg.0000593588.63281.09","article-title":"1013\u2003The Effect of Steatosis on the Clinical Course of Autoimmune Hepatitis","volume":"114","author":"Davis","year":"2019","journal-title":"Am J Gastroenterol"},{"key":"2025090708493067000_13.e1.e94.29","doi-asserted-by":"crossref","first-page":"2710","DOI":"10.1007\/s10620-016-4213-3","article-title":"Natural history of patients presenting with autoimmune hepatitis and coincident nonalcoholic fatty liver disease","volume":"61","author":"De Luca-Johnson","year":"2016","journal-title":"Dig Dis Sci"},{"key":"2025090708493067000_13.e1.e94.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2014.05.021"},{"key":"2025090708493067000_13.e1.e94.31","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24141"},{"key":"2025090708493067000_13.e1.e94.32","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1016\/j.jhep.2020.12.033","article-title":"Early liver transplantation for corticosteroid non-responders with acute severe autoimmune hepatitis: the SURFASA score","volume":"74","author":"De Martin","year":"2021","journal-title":"J Hepatol"},{"key":"2025090708493067000_13.e1.e94.33","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26678"},{"key":"2025090708493067000_13.e1.e94.34","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24080"},{"key":"2025090708493067000_13.e1.e94.35","article-title":"Autoimmune liver disease: EASL clinical practice guidelines and future directions","volume":"10","year":"2016","journal-title":"Hepatology International"},{"key":"2025090708493067000_13.e1.e94.36","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2007.08.013"},{"key":"2025090708493067000_13.e1.e94.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.08.018"},{"key":"2025090708493067000_13.e1.e94.38","doi-asserted-by":"crossref","DOI":"10.1111\/liv.15241","article-title":"Treatment and outcome of autoimmune hepatitis (AIH): audit of 28 UK centres","author":"Gordon","year":"2022","journal-title":"Liver Int"},{"key":"2025090708493067000_13.e1.e94.39","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1038\/ajg.2015.139","article-title":"Long-Term prognostic significance of persisting histological activity despite biochemical remission in autoimmune hepatitis","volume":"110","author":"Dhaliwal","year":"2015","journal-title":"Am J Gastroenterol"},{"key":"2025090708493067000_13.e1.e94.40","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199510123331502"},{"key":"2025090708493067000_13.e1.e94.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2016.05.023"},{"key":"2025090708493067000_13.e1.e94.42","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2017.11.020"},{"key":"2025090708493067000_13.e1.e94.43","doi-asserted-by":"crossref","first-page":"985","DOI":"10.1111\/liv.14082","article-title":"Long-term clinical outcomes in patients with autoimmune hepatitis according to treatment response in Asian country","volume":"39","author":"Choi","year":"2019","journal-title":"Liver Int"},{"key":"2025090708493067000_13.e1.e94.44","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.12.041"}],"container-title":["Frontline Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/flgastro-2022-102192","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,7]],"date-time":"2025-09-07T15:49:42Z","timestamp":1757260182000},"score":1,"resource":{"primary":{"URL":"https:\/\/fg.bmj.com\/lookup\/doi\/10.1136\/flgastro-2022-102192"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,9]]},"references-count":44,"journal-issue":{"issue":"e1","published-online":{"date-parts":[[2022,6,20]]},"published-print":{"date-parts":[[2022,8]]}},"alternative-id":["10.1136\/flgastro-2022-102192"],"URL":"https:\/\/doi.org\/10.1136\/flgastro-2022-102192","relation":{},"ISSN":["2041-4137","2041-4145"],"issn-type":[{"type":"print","value":"2041-4137"},{"type":"electronic","value":"2041-4145"}],"subject":[],"published":{"date-parts":[[2022,6,9]]}}}