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
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