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Liver autoimmunity

This section deals with the clinical condition liver autoimmunity, listing the relevant immunological tests, together with a short explanation of their use.

Relevant immunological tests:

Primary biliary cirrhosis (PBC) and autoimmune chronic active hepatitis (CAH) are associated with characteristic autoantibodies that are helpful in classifying the hepatitis and separating autoimmune CAH from the other forms.

Patterns may include antibodies to smooth muscle (actin), reported as SMA-T in CAH, liver/kidney microsomal antibodies in LKM-positive autoimmune hepatitis and antibodies to mitochondria PBC.

Centromere antibodies are also found in some cases of primary biliary cirrhosis. Presence of autoantibodies does not exclude a viral cause for the hepatitis.

Because of the overlap between various different forms of hepatitis, it is usually best to test for all the types of autoantibody - AMA, SMA, LKM and ANA. There is a polyclonal increase in immunoglobulins in autoimmune and viral hepatitis, whilst a raised IgM is seen in primary biliary cirrhosis. Serum electrophoresis may reveal lack of alpha-1-antitrypsin if this is associated with the cirrhosis.

Primary sclerosing cholangitis has no definitive serological markers, but may be associated with ANCA (anti-neutrophil cytoplasmic antibodies) or ANA or SMA.


(Last updated October 10th 2014)