Histopathologic criteria to differentiate autoimmune hepatitis from chronic viral hepatitis (B, C) in liver biopsy

Abstract

Abstract Introduction Chronic hepatitis is a common disease in the community which is caused mainly by viral agents or immune factors. Differential diagnosis of hepatitis in the treatment is very important due to different therapy. Aim This study is designed to determine importance of histological findings of autoimmune hepatitis (AIH) to distinguish from other chronic hepatitis. Material and methods In a cross-sectional study, 112 patients with hepatitis (autoimmune, B and C) were assessed about histopathological criteria on liver biopsy. Results Among the 12 indicators in histopathologic criteria, 5 indexes of interface hepatitis, lymphoid follicle in port area, emperipolesis, hepatic rosette and ground glass hepatocyte have the ability to differentiate types of hepatitis. Discussion Clinical and laboratory features of hepatitis B and C can overlap with those of AIH. From therapeutic point of view, distinguishing AIH from viral hepatitis is vital, as their treatment is totally different. Some histopathologic criteria on liver biopsy accompanied with other clinical and paraclinical findings help differentiation of them. Conclusions Histopathological parameters can differentiate types of hepatitis at an acceptable level which among them, interface hepatitis is used to differentiate between AIH and hepatitis B, lymphoid follicle in port area is used to differentiate hepatitis C and the other two types, emperipolesis to differentiate AIH from the other two types, hepatic rosette to differentiate AIH from the other two types and ground glass hepatocyte to differentiate hepatitis B from the other two types.