Table 1.
ANA | Variably expressed with ASMA in type 1 AIH |
Heterogenous antigen profile | |
No single staining pattern is pathognomonic for diagnosis of AIH | |
Most useful when found with ASMA (diagnostic accuracy 74%)[20] | |
ASMA | Marker of type 1 AIH along with ANA |
Reacts to several cytoskeletal elements, especially F-actin. | |
ELISA against F-actin as the substrate can be used instead of indirect immunofluorescence but may miss the diagnosis in 15% to 20% of cases[20] | |
Anti-SLA/LP | Only disease specific antibody with specificity of 99% for AIH |
Present in only 15% patients with AIH in the United States | |
Known to have a defined antigen, SEPSECS. ELISA is the preferred methodology of testing | |
Closely associated with HLA DRB1*03 and Anti-Ro/SSA | |
Have prognostic value as it is associated with severe disease, higher risk of relapse and need for lifelong treatment | |
Anti-LKM1 | Serologic marker for type 2 AIH. |
CYP2D6 is the target antigen. Shares homology with hepatitis C virus antigen | |
Present mainly in children, worldwide. Rare in adults in the United States (< 4%) | |
Associated with HLA DRB*07 | |
Atypical pANCA | Common in type 1 AIH, and absent in type 2 AIH |
Associated with PSC, UC |
ANA: Antinuclear antibodies; ASMA: Anti-smooth muscle antibodies; AIH: Autoimmune hepatitis; ELISA: Enzyme linked immunosorbent assay; Anti-SLA/LP: Anti-soluble liver antigen/liver pancreas antibody; SEPSECSA: Sep (phosphoserine) tRNA: Sec (selenocysteine) tRNA synthase; Ro/SSA: Ribonucleoprotein/Sjögren’s syndrome A protein; Anti-LKM1: Antibodies to liver kidney microsome type 1; pANCA: Perinuclear antineutrophil cytoplasmic antibodies; PSC: Primary sclerosing cholangitis; UC: Ulcerative colitis.