Ondokuz Mayis University, Faculty of Medicine, Department of Gastroenterology - Samsun, Turkey.
Abant Izzet Baysal University Hospital, Department of Internal Medicine - Bolu, Turkey.
Rev Assoc Med Bras (1992). 2024 Jan 26;70(1):e20230905. doi: 10.1590/1806-9282.20230905. eCollection 2024.
Autoimmune hepatitis is a rare inflammatory disease of the liver that is characterized by elevated liver enzymes. The hemoglobin, albumin, lymphocyte, and platelet score, which is derived from hemoglobin, serum albumin, circulating lymphocyte count, and platelet count, is also associated with inflammatory conditions. The aim was to examine the hemoglobin, albumin, lymphocyte, and platelet score of patients with autoimmune hepatitis and to compare it to that of healthy individuals in this retrospective analysis.
Subjects diagnosed with autoimmune hepatitis were enrolled in the study, and healthy individuals were enrolled as controls. Moreover, autoimmune hepatitis subjects were grouped into mild or moderate/advanced fibrosis. Furthermore, aspartate to platelet ratio index, Fibrosis-4, and hemoglobin, albumin, lymphocyte, and platelet scores of the autoimmune hepatitis patients and controls were compared. In addition, the hemoglobin, albumin, lymphocyte, and platelet score of the autoimmune hepatitis patients with mild fibrosis is compared to that of those with moderate/advanced fibrosis.
The mean hemoglobin, albumin, lymphocyte, and platelet score of the autoimmune hepatitis patients was 44.2±14.5 while this value was 76.8±15.5 in control subjects. The hemoglobin, albumin, lymphocyte, and platelet score was significantly reduced in autoimmune hepatitis patients than healthy controls (p<0.001). The hemoglobin, albumin, lymphocyte, and platelet score was significantly and negatively correlated with C-reactive protein, aspartate, alanine transaminase, gamma glutamyl transferase, aspartate to platelet ratio index, and Fibrosis-4 values. A hemoglobin, albumin, lymphocyte, and platelet score that was lower than 52.3 had 83% sensitivity and 73% specificity in predicting autoimmune hepatitis. The sensitivity and specificity of the hemoglobin, albumin, lymphocyte, and platelet score were higher than the Fibrosis-4 score in predicting moderate/advanced fibrosis in autoimmune hepatitis.
We suggest that the hemoglobin, albumin, lymphocyte, and platelet score be used as an additional noninvasive diagnostic tool for autoimmune hepatitis and to predict moderate/advanced liver fibrosis in patients with autoimmune hepatitis.
自身免疫性肝炎是一种罕见的肝脏炎症性疾病，其特征是肝酶升高。血红蛋白、白蛋白、淋巴细胞和血小板评分（由血红蛋白、血清白蛋白、循环淋巴细胞计数和血小板计数推导得出）也与炎症状态有关。本研究旨在检查自身免疫性肝炎患者的血红蛋白、白蛋白、淋巴细胞和血小板评分，并与健康个体进行比较。
本研究纳入了诊断为自身免疫性肝炎的患者，并纳入健康个体作为对照。此外，将自身免疫性肝炎患者分为轻度或中/重度纤维化。进一步比较了自身免疫性肝炎患者和对照组的天门冬氨酸转氨酶血小板比值指数、纤维化-4 以及血红蛋白、白蛋白、淋巴细胞和血小板评分。此外，还比较了轻度纤维化和中/重度纤维化自身免疫性肝炎患者的血红蛋白、白蛋白、淋巴细胞和血小板评分。
自身免疫性肝炎患者的平均血红蛋白、白蛋白、淋巴细胞和血小板评分为 44.2±14.5，而对照组为 76.8±15.5。自身免疫性肝炎患者的血红蛋白、白蛋白、淋巴细胞和血小板评分明显低于健康对照组（p<0.001）。血红蛋白、白蛋白、淋巴细胞和血小板评分与 C 反应蛋白、天门冬氨酸转氨酶、丙氨酸转氨酶、γ-谷氨酰转移酶、天门冬氨酸转氨酶血小板比值指数和纤维化-4 值呈显著负相关。血红蛋白、白蛋白、淋巴细胞和血小板评分低于 52.3 时，预测自身免疫性肝炎的敏感性为 83%，特异性为 73%。在预测自身免疫性肝炎的中/重度纤维化时，血红蛋白、白蛋白、淋巴细胞和血小板评分的敏感性和特异性均高于纤维化-4 评分。
我们建议将血红蛋白、白蛋白、淋巴细胞和血小板评分作为自身免疫性肝炎的一种额外的非侵入性诊断工具，并预测自身免疫性肝炎患者的中/重度肝纤维化。
