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They are particularly associated with autoimmune hepatitis, but can also be seen in other autoimmune and liver-related diseases.
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| Parameter | Details |
|---|---|
| Full Name | Anti-Smooth Muscle Antibodies (ASMA) |
| Sample Type | Blood (Serum) |
| Fasting Required | ❌ No |
| Method | IFA (Indirect Immunofluorescence Assay) / ELISA |
| Turnaround Time | 3–5 days |
Anti-smooth muscle antibodies (ASMA) are autoantibodies that target the actin filaments in smooth muscle cells. These antibodies are produced when the immune system mistakenly attacks the body’s own smooth muscle tissue.
They are particularly associated with autoimmune hepatitis, but can also be seen in other autoimmune and liver-related diseases.
| Organ/System | Relevance |
|---|---|
| Liver | Primary organ affected in autoimmune hepatitis |
| Muscles (Smooth muscle) | Immune response targets smooth muscle tissue (vascular, intestinal walls) |
| Clinical Purpose | Usage |
|---|---|
| Diagnose Autoimmune Hepatitis (AIH) | ASMA is a key marker for type 1 autoimmune hepatitis |
| Differentiate from other liver disorders | Helps rule out viral, alcoholic, or drug-induced hepatitis |
| Assess for autoimmune liver disease overlap | Especially when combined with ANA and LKM antibodies |
| Monitor autoimmune hepatitis activity | Can support diagnosis with liver biopsy and LFTs |
| Result | Meaning |
|---|---|
| Negative (<1:20) | No significant ASMA present; autoimmune hepatitis unlikely |
| Low Positive | Possible low-grade autoimmunity or non-specific inflammation |
| High Positive (>1:80) | Suggestive of autoimmune hepatitis, especially with elevated liver enzymes |
A liver biopsy and clinical correlation are often required for a definitive diagnosis.
| Condition | ASMA Role |
|---|---|
| Autoimmune Hepatitis (Type 1) | Present in ~80% of cases |
| Chronic active hepatitis | Often associated |
| Primary biliary cholangitis (PBC) | May overlap with AIH |
| Systemic autoimmune diseases | Sometimes seen in lupus, RA, or connective tissue disorders |
| Viral hepatitis | Rarely mildly positive in acute viral hepatitis (non-specific) |
| Test | Why It's Useful | |
|---|---|---|
| ANA (Antinuclear Antibody) | Often positive in autoimmune liver disease | |
| Anti-LKM (Liver Kidney Microsomal Antibodies) | Helps classify autoimmune hepatitis types | |
| Liver Function Tests (LFTs) | ALT, AST, Bilirubin, ALP – to assess liver inflammation | |
| IgG (Immunoglobulin G) Levels | Often elevated in autoimmune hepatitis | |
| Liver Biopsy | Confirms diagnosis and grades severity of liver inflammation | |
| Anti-Mitochondrial Antibody (AMA) | Rules out primary biliary cholangitis |
Patients with:
o Unexplained elevated liver enzymes
o Fatigue, jaundice, or abdominal pain
o History of other autoimmune disorders
Women (more commonly affected by AIH)
Children or adolescents with liver dysfunction (Type 1 AIH)
| Test Name | Anti-Smooth Muscle Antibodies (ASMA) |
|---|---|
| Primary Use | Diagnose autoimmune hepatitis (Type 1) |
| Target Organ | Liver |
| Method | IFA / ELISA |
| Often Ordered With | ANA, LFTs, IgG, Anti-LKM, Liver Biopsy |
| Associated Conditions | Autoimmune hepatitis, chronic active hepatitis, PBC |
| Fasting Required | ❌ No |
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