Is it time to get rid of the biopsy mandate in adults with suspected Autoimmune hepatitis? Lessons from the COVID‐19 pandemic.

Liver biopsy is required to make a diagnosis of autoimmune hepatitis. During the COVID-19 pandemic there have been calls to commence empirical treatment in patients with suspected disease who have characteristic clinical, biochemical and immunological features. It is suggested to modify the current simplified autoimmune hepatitis scoring system to include two additional criteria – No history of drug-induced liver injury-associated medications and response to immunosuppressive treatment - that if fulfilled, could be considered as an alternative to a histological confirmation.

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