Diagnostic value of homocysteine combined with IgG in differentiating drug- induced liver injury and autoimmune hepatitis

Abstract This study aims to investigate the diagnostic utility of homocysteine and IgG in distinguishing drug-induced liver injury from autoimmune hepatitis. A total of 181 patients with drug-induced liver damage and 143 patients with autoimmune hepatitis were included in this retrospective study. The clinical baseline data, homocysteine and IgG levels of the two groups were compared. The diagnostic sensitivity and specificity were determined using receiver operating characteristic (ROC) curves, and the diagnostic values were compared using the area under the receiver operating curve (AUROC). At a critical value of 10.05, the diagnostic sensitivity of homocysteine for autoimmune hepatitis was 88.1%, with a specificity of 92.3% and an AUROC of 0.881 (95% CI, [0.834 ~ 0.927]). When the critical value was 15.31, the AUROC for the diagnosis of autoimmune hepatitis by IgG was 0.732 (95% CI, 0.677 to 0.788). The combination of homocysteine and IgG resulted in an AUROC of 0.903 (95% CI, [0.864 ~ 0.942]), indicating a notable enhancement in diagnostic performance. Homocysteine has the potential to assist in the accurate differentiation between drug-induced liver injury and autoimmune hepatitis. Furthermore, the utilization of homocysteine in conjunction with IgG enhances its diagnostic efficacy.