Frequency of seronegative cases in autoimmune hepatitis and their association with the systemic immune inflammation index

Year 2024, Volume: 7 Issue: 2, 230 - 235, 25.03.2024

Nermin Mutlu Bilgiç

https://doi.org/10.32322/jhsm.1446058

Abstract

Aims: It is suggested that a deficiency in B cells plays a role in pathogenesis of seronegative autoimmune hepatitis (snAIH). The lack of B cells leads to notable changes in the variety of leukocyte types within the bloodstream. This study aimed to determine the frequency of snAIH in patients with autoimmune hepatitis, as well as to explore the relationship between snAIH and leukocyte-based inflammatory indices.
Methods: In this retrospective study, 57 patients newly diagnosed with autoimmune hepatitis were included. According to clinical and pathological findings, patients were classified into seropositive autoimmune hepatitis (spAIH) and snAIH groups. The inflammation indices included the platelet to lymphocyte ratio (PLR), the neutrophil to lymphocyte ratio (NLR), and the systemic immune-inflammation index (SII).
Results: The frequency of snAIH was 26.3%. The snAIH group exhibited higher NLR (3.0 vs. 1.5, p<0.001) and SII (726.1 vs. 300.8, p<0.001) levels, along with a lower PLR level (118.2 vs. 151.1, p=0.001) than the spAIH group. The threshold value of SII in predicting snAIH was ≥488.4 (sensitivity=80.9%, specificity=86.7%), and it exhibited better diagnostic performance than other inflammatory indices.
Conclusion: In autoimmune hepatitis patients, snAIH exhibits by a notable prevalence and a different inflammatory landscape. For patients suspected of autoimmune hepatitis but negative for autoantibodies, the SII could serve as a straightforward, accessible, and affordable predictor prior to liver biopsy.

Keywords

Autoimmune hepatitis, Seronegative, inflammation index

Ethical Statement

This study was performed in accordance with the Declaration of Helsinki, and approved by the University of Health Sciences, Umraniye Training and Research Hospital, Clinical Research Ethics Committee (Date: 22 December 2023, Decision No. 232416878).

Project Number

232416878

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