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KMID : 0882420130840020211
Korean Journal of Medicine
2013 Volume.84 No. 2 p.211 ~ p.220
The Clinical Significance of Simplified Scoring Criteria as a Diagnostic Tool for Overlap Syndrome in Korea
Kim Min-Suk

Kim Young-Seok
Kim Sang-Gyune
Byun Jin-Myung
Yoon La-Young
Han Dong-Hoon
Moon Jong-Joo
Nam Jae-Hyung
Kim Tae-Jin
Lee Sae-Hwan
Jung Seung-Won
Kim Hong-Soo
Kim Boo-Sung
Kim Hee-Kyung
Abstract
Background/Aims: The diagnosis of primary billiary cirrhosis (PBC)-autoimmune hepatitis (AIH) overlap syndrome remains challenging. In 2008, a simplified scoring system was proposed by the International Autoimmune Hepatitis Group, which aimed for wider applicability in routine clinical practice. We evaluated the performance of the new simplified AIH scoring criteria as a diagnostic tool for overlap syndrome.

Methods: We retrospectively reviewed the clinical histories, chemistry, autoimmune studies, and liver biopsy results of 25 patients diagnosed with PBC who visited Soonchunhyang University Hospital, Bucheon and Seoul, between November 2004 and December 2009. Parameters relevant to the revised and simplified scoring criteria were recorded, and outcomes were compared between those with and without features of overlap syndrome.

Results: Of 25 patients with a definite diagnosis of PBC, five (20%) were diagnosed with overlap syndrome using the revised criteria, and 18 patients (72%) were diagnosed with the simplified criteria. Those patients diagnosed according to the simplified scoring criteria revealed an increased frequency of anti-nuclear antibody (p = 0.030) and serum IgG levels (p = 0.092). Additionally, advanced fibrosis was significantly more frequent in patients with overlap syndrome (p = 0.017).

Conclusions: The simplified scoring criteria seemed to be useful as a diagnostic tool to recognize overlap syndrome in Korea. However, a relatively small number of patients were included in our study, so further clinical trials based on larger populations should be performed.
KEYWORD
Liver cirrhosis, Biliary, Hepatitis, Autoimmune, Diagnosis
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