Search for
Soluble Liver Antigen(SLA) serum by Immunoblot
Liver
Report in 48Hrs
At Home
No Fasting Required
Details
Autoantibody test.
₹3,522₹5,032
30% OFF
Soluble Liver Antigen (SLA) Serum by Immunoblot - Comprehensive Guide
- Why is it done?
- Purpose of the Test: The SLA immunoblot detects antibodies against soluble liver antigen (also known as UGA suppressor tRNA-associated antigen, or USALPA). This test measures specific autoantibodies targeting liver cell proteins in the serum.
- Primary Indications: Diagnosis of autoimmune hepatitis (AIH), particularly AIH Type 2 and AIH Type 3 when other autoimmune markers are negative; evaluation of unexplained liver disease with suspected autoimmune etiology; assessment of patients with cryptogenic hepatitis.
- Clinical Circumstances: Performed when patients present with elevated liver enzymes (ALT, AST), elevated bilirubin, and compatible histological findings; particularly useful in cases seronegative for anti-mitochondrial antibodies (AMA) and anti-smooth muscle antibodies (ASMA); performed during initial workup of suspected autoimmune liver disease.
- Normal Range
- Reference Values: Negative or Absent - No detectable SLA antibodies; reported as negative or <1.0 (when quantitative methods are used); Unit: Qualitative (positive/negative) or titer if quantitative.
- Result Interpretation: Negative Result (Normal) - Absence of SLA antibodies; suggests autoimmune hepatitis is less likely unless other specific autoantibodies (anti-LKM, anti-SMA) are present; does not exclude autoimmune liver disease but reduces probability of SLA-positive AIH.
- Positive Result (Abnormal) - Detectable SLA antibodies present; highly suggestive of autoimmune hepatitis, particularly when accompanied by compatible clinical and laboratory findings; positive result is uncommon but highly specific for AIH when present.
- Clinical Correlation: Results must be interpreted with clinical context including liver function tests, imaging findings, and liver biopsy histology when available; positive SLA alone is not diagnostic without compatible clinical presentation.
- Interpretation
- Positive SLA Antibodies: Indicates autoimmune hepatitis, especially when found in seronegative patients lacking anti-LKM and anti-smooth muscle antibodies; SLA positivity is associated with more severe disease and earlier disease presentation; suggests need for immunosuppressive therapy; found in approximately 10-30% of AIH patients.
- Negative SLA Antibodies: Does not exclude autoimmune hepatitis; may indicate seronegative AIH, hepatitis caused by viral infections, metabolic disorders, drug-induced liver injury, or primary biliary cholangitis; requires further testing including anti-LKM, anti-mitochondrial antibodies, and liver biopsy if clinically indicated.
- Factors Affecting Results: Immunosuppressive therapy may suppress antibody production over time; disease remission may be associated with declining titers; test sensitivity and specificity vary depending on methodology (immunoblot vs. ELISA); timing of blood draw relative to disease activity; concurrent autoimmune conditions may affect results; liver biopsy showing portal inflammation and interface hepatitis increases likelihood of true AIH diagnosis.
- Clinical Significance: SLA antibodies are highly specific for autoimmune hepatitis when positive; particularly important marker for AIH Type 3 and seronegative AIH cases; presence of SLA predicts good response to immunosuppressive therapy; useful for disease monitoring and prognostication; may indicate more progressive disease requiring aggressive treatment.
- Associated Organs
- Primary Organ System: Hepatic (liver) system; specifically targets hepatocytes and liver cytoplasm; may indicate systemic autoimmune dysfunction affecting other organs.
- Associated Medical Conditions: Autoimmune hepatitis (AIH) Types 1, 2, and 3; seronegative autoimmune hepatitis; cryptogenic hepatitis; may be present with concurrent autoimmune disorders (thyroiditis, celiac disease, systemic lupus erythematosus); associated with chronic liver inflammation and cirrhosis if untreated.
- Diseases Aided in Diagnosis: Autoimmune hepatitis; helps differentiate AIH from viral hepatitis, alcoholic liver disease, nonalcoholic fatty liver disease, primary biliary cholangitis, primary sclerosing cholangitis, drug-induced liver injury, and metabolic liver diseases; useful in distinguishing immune-mediated from other causes of liver dysfunction.
- Potential Complications of Abnormal Results: Untreated autoimmune hepatitis leads to progressive liver fibrosis and cirrhosis; hepatic decompensation with ascites, encephalopathy, and variceal bleeding; hepatocellular carcinoma development; acute liver failure in fulminant cases; need for liver transplantation if disease progresses; systemic complications from associated autoimmune phenomena.
- Follow-up Tests
- Recommended Additional Tests: Anti-liver-kidney microsomal (anti-LKM) antibodies; anti-smooth muscle antibodies (anti-SMA); anti-nuclear antibodies (ANA); anti-mitochondrial antibodies (AMA); anti-tissue transglutaminase (anti-tTG) for celiac screening; total immunoglobulin G (IgG) levels; liver function tests (ALT, AST, ALP, total/direct bilirubin).
- Further Investigations: Liver biopsy with histological examination for inflammation, fibrosis staging, and interface hepatitis; ultrasound or CT imaging to assess liver echotexture and exclude cirrhosis; hepatitis A, B, and C serology to exclude viral hepatitis; alcohol and drug history assessment; assessment for other autoimmune conditions.
- Monitoring Frequency: Initial presentation: baseline testing at diagnosis; treatment initiation: monthly to quarterly during first year of therapy; maintenance: every 6-12 months during remission; repeat SLA testing may be performed annually or as clinically indicated to assess response to immunosuppressive therapy; more frequent monitoring if disease is active or therapy changes.
- Complementary Testing: FibroScan or transient elastography for liver stiffness assessment; platelet count and PT/INR for synthetic liver function; albumin levels; prealbumin; alpha-fetoprotein (AFP) if cirrhosis suspected; regular assessment of treatment response through serological and biochemical markers.
- Fasting Required?
- Fasting Requirement: No - Fasting is NOT required for SLA immunoblot testing
- Specimen Collection: Simple serum sample collection via venipuncture; no special preparation needed; can be drawn at any time of day; patient may eat and drink normally before test.
- Medication Instructions: Continue all regular medications unless specifically instructed otherwise by physician; immunosuppressive therapy (corticosteroids, azathioprine, 6-mercaptopurine) should be continued as prescribed; no medications need to be held before test; inform laboratory of current medications as some may affect antibody production over time.
- Patient Preparation: No special preparation required; patient may maintain normal diet and hydration; wear loose, comfortable clothing for easy venipuncture; arrive hydrated as this facilitates blood draw; inform phlebotomist of any bleeding disorders or difficulty with blood draws; no exercise restrictions required before test; samples should be collected in appropriate serum separator tubes per laboratory protocol.
How our test process works!
