Autoimmune liver diseases screen

Indication

Suspicion of autoimmune liver disease.

Method

Immunoblot

Response

The test result is given as negative or positive with a numeric result for the reaction’s intensity.

Interpretation

Antibodies against AMA-M2
The antibodies are directed to the pyruvate dehydrogenase complex on the internal membrane of the mitochondrial, i.e.M2-antigen. Antibodies against mitochondrial type M2 are markers for primary biliary cholangitis (PBC) and occur in more than 90% of the cases. Overlap between PBC and autoimmune hepatitis (AIH) occurs, and therefore, AIH markers can sometimes be detected simultaneously with AMA-M2. PBC can also be seen in systemic sclerosis. PBC is a cholestatic disease that is caused by inflammation of the bile ducts with consequently cholestatic liver values.

Antibodies against M2-3E (BPO)
M2-3E (BPO) is a recombinant fusion protein consisting of different subunits of the enzyme complex M2. Antibodies against mitochondrial type M2 are markers for primary biliary cholangitis (PBC) and occur in more than 90% of the cases. Overlap between PBC and autoimmune hepatitis (AIH) occurs, and therefore, AIH markers can sometimes be detected simultaneously with AMA-M2. PBC can also be seen in systemic sclerosis. PBC is a cholestatic disease that is caused by inflammation of the bile ducts with consequently cholestatic liver values.

Antibodies against SP100
Sp100 is an antigen in cell nuclei. Antibodies against Sp100 are a strong marker for PBC (primary biliary cholangitis) and may occur with or without simultaneous occurrence of AMA-M2.

Antibodies against PML
PML is a nuclear antigen, and antibodies against PML may in some cases be seen in PBC (primary biliary cholangitis).

Antibodies against gp210
gp210 is a protein in the cell nucleus membrane. Antibodies against gp210 are a strong marker for PBC (primary biliary cholangitis) and are associated with an aggressive disease course.

Antibodies against LKM-1
Antibodies against LKM-1 are markers for autoimmune hepatitis (AIH) type 2.

Antibodies against LC-1
Antibodies against LC-1 occur in up to 50% of the cases with autoimmune hepatitis (AIH) type 2 and are most commonly seen with LKM-1 antibodies. Isolated occurrence of anti-LC1 occurs in approximately 10% of the cases. High level of anti-LC1 is associated with a more serious disease course. In some cases, anti-LC-1 has been reported in hepatitis C.

Antibodies against SLA/LP
Antibodies against SLA/LP are strong markers for autoimmune hepatitis (AIH) type 1 and occur in about 10% of the cases. Anti-SLA may occur without the presence of ANA and/or anti-smooth muscle antibodies.

Antibodies against Ro52
Anti-SSA/Ro52 is directed against an immunoglobulin intracellular receptor and is associated with several different autoimmune conditions, such as autoimmune hepatic disease, myositis and inflammatory systemic diseases. In pregnancy, antibodies to SSA/Ro52 are associated with cardiac arrhythmia and cardiac blockages in the fetus. However, the risk of this is low and estimated at approximately 3% in mothers with known SLE/Sjögrens syndrome. The risk of mothers with these antibodies but without known rheumatic disease is unknown, but probably even lower. It is recommended that the fetus's heart rate is checked weekly during the critical period of the pregnancy, weeks 18-24.

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