Abstract: Objective The aim of this study was to explore the diagnostic value of serum anti-fumarate hydratase (anti-FH) in patients with autoimmune hepatitis (AIH). Methods 166 patients with liver disease, including AIH in 52, chronic hepatitis B (CHB) in 81 and drug-induced liver injury (DILI)]in 33, were recruited in our hospital between February 2018 and May 2019. Serum anti-FH and antinuclear antibody were detected by ELISA. Results Serum GGT, ALP and IgG levels in patients with AIH were (304.6±28.1)U/L, (258.1±24.0)U/L and (24.7±1.9)g/L, significantly higher than 【(104.5±12.3)U/L, (85.7±9.2)U/L and (15.2±1.5)g/L, respectively, P<0.05】 in patients with CHB and serum IgG level was also much higher than 【(14.8±1.2)g/L, P<0.05】 in patients with DILI, and serum bilirubin and ALT levels in the three groups were not significantly different (P>0.05); serum anti-FH positive rate in patients with AIH was 36.5%, significantly higher than 6.1% in patients with DILI or 3.7%(P<0.05) in those with CHB; serum ANA positive rate in patients with AIH was 73.1%, significantly higher than 54.5% in DILI patients or 50.6%(P<0.05) in CHB patients; the sensitivity (Se), specificity (Sp), Yorden index, positive predictive value and negative predictive value by serum anti-FH in diagnosing AIH were 36.5%, 95.6%, 0.3, 35.2% and 76.8%, while those by serum anti-FH and ANA combination were 76.9%, 44.7%, 0.2, 38.8% and 80.9%, respectively, meaning the Se increased, while the Sp decreased greatly. Conclusion Serum anti-FH has a high diagnostic specificity for patients with AIH, which under some circumstances might have a good differential effect in clinical practice.

Key words: Autoimmune hepatitis, Anti-fumarate hydratase, Antinuclear antibody, Diagnosis