Copyright
©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2026; 18(1): 114045
Published online Jan 27, 2026. doi: 10.4254/wjh.v18.i1.114045
Published online Jan 27, 2026. doi: 10.4254/wjh.v18.i1.114045
Not always autoimmune hepatitis: Hepatic steatosis is associated with autoantibodies positivity in patients with hepatocellular dysfunction
Ana Isabel Ferreira, Vitor Macedo Silva, Sofia Xavier, Joana Magalhães, José Cotter, Department of Gastroenterology, Unidade Local de Saúde do Alto Ave, Guimaraes 4835-044, Portugal
Ana Isabel Ferreira, Vitor Macedo Silva, Sofia Xavier, Joana Magalhães, José Cotter, Life and Health Sciences Research Institute, School of Medicine, University of Minho, Braga 4710-057, Portugal
Ana Isabel Ferreira, Vitor Macedo Silva, Sofia Xavier, Joana Magalhães, José Cotter, ICVS/3B’s, PT Government Associate Laboratory, Braga 4710-057, Portugal
Mariana Costa Azevedo, School of Medicine, University of Minho, Braga 4710-057, Portugal
Author contributions: Ferreira AI, Azevedo MC, Silva VM, Xavier S, Magalhães J, Cotter J contributed to the study conception and design; material preparation, data collection and analysis were performed by Ferreira AI; the first draft of the manuscript was written by Ferreira AI, and all authors commented on previous versions of the manuscript, read and approved the final manuscript.
Institutional review board statement: The study protocol conforms to the ethical guidelines of the 1975 Declaration of Helsinki as reflected in a priori approval by the Institutional Review Board (Ref: 116/2023).
Informed consent statement: The need for written informed consent was waived by the Ethics Review Board since this is a retrospective study.
Conflict-of-interest statement: All authors have no conflicts of interest to declare.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: The datasets generated and/or analyzed during the current study are not publicly available due to ethical concerns but are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ana Isabel Ferreira, MD, Department of Gastroenterology, Unidade Local de Saúde do Alto Ave, R. dos Cutileiros 114, Creixomil, Guimaraes 4835-044, Portugal.
Received: September 11, 2025
Revised: October 9, 2025
Accepted: November 25, 2025
Published online: January 27, 2026
Processing time: 139 Days and 15.9 Hours
Revised: October 9, 2025
Accepted: November 25, 2025
Published online: January 27, 2026
Processing time: 139 Days and 15.9 Hours
Core Tip
Core Tip: This retrospective study included 81 consecutive adult patients with liver dysfunction and positive autoantibodies undergoing liver biopsy. Autoimmune hepatitis was not confirmed in 47% of patients. In patients with anti-nuclear antibodies positivity, male gender and higher controlled attenuation parameter values emerged as independent predictive factors associated with non-confirmed diagnosis of autoimmune hepatitis. These findings generate a valuable hypothesis that may inform future updates to clinical decision algorithms, particularly considering the rising prevalence of metabolic dys