Search for
Autoimmune Liver Disease Profile
Liver
4 parameters
Report in 24Hrs
At Home
No Fasting Required
Details
Autoantibody panel (AMA, LKM, SLA).
₹6,999₹10,351
32% OFF
Parameters
- List of Tests
- Anti Smooth Muscle Antibody
- LKM1 Antibodies
- ANA Screeing by IFA
- Anti Mitochondrial Antibody
Autoimmune Liver Disease Profile
- Why is it done?
- Detects specific autoimmune antibodies that target liver tissue and bile duct cells
- Diagnoses autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC)
- Ordered when patients present with chronic liver inflammation, elevated liver enzymes, or jaundice
- Anti Smooth Muscle Antibody (ASMA): Identifies antibodies against smooth muscle cells, a hallmark of autoimmune hepatitis type 1
- LKM1 Antibodies: Detects liver-kidney microsomal antibodies, characteristic of autoimmune hepatitis type 2
- ANA Screening by IFA: Screens for antinuclear antibodies indicating systemic autoimmune involvement
- Anti Mitochondrial Antibody (AMA): Identifies antibodies targeting mitochondrial proteins, specifically diagnostic for primary biliary cholangitis
- Helps differentiate between various forms of autoimmune liver disease for appropriate treatment selection
- Recommended when evaluating patients with unexplained hepatitis, cirrhosis, or abnormal liver function tests
- Normal Range
- Anti Smooth Muscle Antibody (ASMA): Negative or <1:40 titer; reported as negative when absent; positive at titers ≥1:40
- LKM1 Antibodies: Negative or <1:40 titer; presence of detectable antibodies is abnormal and suggests disease
- ANA Screening by IFA: Negative (reported as Negative or <1:40 titer); borderline results may range from 1:40 to 1:80; positive when ≥1:80
- Anti Mitochondrial Antibody (AMA): Negative or <1:40 titer; positive results indicate ≥1:40 titer with specific M2 subtype identification
- All results are expressed qualitatively (Negative/Positive) with quantitative titers when positive
- Negative interpretation: Antibodies are not detected; does not completely exclude autoimmune liver disease but makes it less likely
- Positive interpretation: Antibodies are present; generally indicates autoimmune liver disease with higher titers suggesting more active disease
- Interpretation
- Anti Smooth Muscle Antibody (ASMA) Positive: Strongly suggests autoimmune hepatitis type 1 (AIH-1); found in 50-80% of AIH-1 patients; higher titers correlate with disease severity
- Anti Smooth Muscle Antibody (ASMA) Negative: Does not exclude autoimmune hepatitis; may be seronegative AIH, other liver diseases, or false negative
- LKM1 Antibodies Positive: Diagnostic of autoimmune hepatitis type 2 (AIH-2); more common in children and young adults; indicates cytochrome P450 1A2 autoimmunity
- LKM1 Antibodies Negative: Does not exclude AIH-2 diagnosis; combined with clinical presentation and other markers determines diagnosis
- ANA Screening by IFA Positive: Suggests autoimmune hepatitis; high titers (≥1:160) more specific for AIH; common in overlap syndromes
- ANA Screening by IFA Borderline (1:40-1:80): May warrant repeat testing; clinical correlation essential; can be positive in non-autoimmune liver disease
- Anti Mitochondrial Antibody (AMA) Positive: Pathognomonic for primary biliary cholangitis (PBC); M2 subtype present in >95% of PBC patients
- Anti Mitochondrial Antibody (AMA) Negative: PBC less likely but not completely excluded; seronegative PBC occurs in 5-10% of cases
- Combined Positive Results: Multiple positive antibodies suggest mixed autoimmune liver disease or overlap syndromes; require specialist evaluation
- False positives may occur with: infections, malignancy, other autoimmune diseases, immunoglobulin replacement therapy, or vaccinations
- Clinical context essential: Results must be interpreted with liver function tests, transaminases, immunoglobulin levels, and liver biopsy findings
- Associated Organs
- Primary organ: Liver - all four tests evaluate hepatic autoimmunity and damage to liver parenchyma and bile ducts
- Anti Smooth Muscle Antibody (ASMA): Targets hepatic smooth muscle and alpha-actin; primary disease - autoimmune hepatitis type 1
- LKM1 Antibodies: Targets liver cytochrome P450 1A2 and kidney microsomal enzymes; affects hepatocytes and renal tubules; primary disease - autoimmune hepatitis type 2
- ANA Screening by IFA: Indicates systemic autoimmunity; can involve multiple organs including liver, kidney, heart, and joints in overlap syndromes
- Anti Mitochondrial Antibody (AMA): Targets mitochondrial matrix enzymes in bile duct epithelium; primarily affects intrahepatic and extrahepatic bile ducts; primary disease - primary biliary cholangitis
- Complications of positive results: Progressive cirrhosis, portal hypertension, hepatic encephalopathy, ascites, variceal bleeding
- Secondary complications: Cholangitis (in PBC), hepatocellular carcinoma development, bone disease (osteoporosis), pruritus, fatigue
- Associated extrahepatic manifestations: Systemic sclerosis, Sjögren syndrome, ulcerative colitis, type 1 diabetes, thyroid disease
- Long-term organ impact: Chronic immune-mediated liver inflammation leads to fibrosis, then cirrhosis, requiring transplantation if untreated
- Follow-up Tests
- Liver Function Tests (ALT, AST, ALP, bilirubin, albumin): Essential for baseline assessment and monitoring disease progression and treatment response
- Immunoglobulin Panel (IgG, IgA, IgM): Measures total immunoglobulin levels; elevated IgG highly suggestive of autoimmune hepatitis
- Complete Metabolic Panel: Evaluates kidney function (LKM1 antibodies can indicate renal involvement), electrolytes, and glucose metabolism
- Coagulation Studies (PT/INR): Assess synthetic liver function and bleeding risk; important before liver biopsy
- Liver Biopsy: Gold standard for diagnosis confirmation; determines grade (inflammation) and stage (fibrosis); guides treatment decisions
- FibroScan/Transient Elastography: Non-invasive assessment of liver fibrosis and cirrhosis; useful for monitoring disease progression
- Anti-nuclear Antibody (ANA) Reflex Panel: If ANA positive, reflex to specific antibodies (anti-dsDNA, anti-Sm, anti-centromere, anti-mitochondrial subtypes)
- Anti-LKM3 and Anti-SLA/LP Testing: Additional autoimmune hepatitis markers if LKM1 negative but clinical suspicion remains high
- Viral Hepatitis Serology: Test for Hepatitis A, B, C to exclude viral causes of hepatitis
- Imaging Studies: Ultrasound or CT scan to evaluate for cirrhosis, portal hypertension, or hepatocellular carcinoma
- Endoscopy: If cirrhosis present, screen for esophageal varices and portal hypertensive gastropathy
- Monitoring Frequency: Every 3-6 months during active disease or treatment initiation; every 6-12 months for stable disease or remission
- Screening for Overlap Syndromes: Test for additional antibodies if features of multiple autoimmune liver diseases present simultaneously
- Fasting Required?
- Fasting Required: No - This test package does not require fasting
- All four antibody tests (ASMA, LKM1, ANA IFA, AMA) can be performed on non-fasting serum samples
- Patient may eat and drink normally before blood collection
- No medications need to be avoided before testing; continue all regularly prescribed medications
- Notify laboratory if patient is on immunosuppressive therapy, biologics, or recent vaccinations as these may affect results
- Blood sample collection: Standard venipuncture into SST or serum separator tube; allow to clot for 30 minutes before centrifugation
- Sample handling: Serum must be separated within 2 hours of collection; refrigerate at 2-8°C if delayed shipping required
- No special diet required; avoid excessive alcohol consumption for several days before testing as it can affect liver function parameters
- Timing consideration: Test can be performed at any time of day; no circadian variation affects antibody levels
- Patient preparation: Arrive for appointment well-rested; ensure adequate hydration to facilitate blood draw
How our test process works!
