Diagnostic value of antisoluble liver antigen/ liver pancreas antigen [SLA/LP] and other autoantibodies in the diagnosis of patients with autoimmune liver disease

ABSTRACT

This study aimed to evaluate the role of auto antibody profile in the diagnosis of patients with suspected autoimmune liver disease and their ability to define the putative type 3 autoimmune hepatitis [AIH]. Forty adult patients with abnormal liver function, elevated serum IgG and negative hepatitis markers were chosen from those attending the Hepatology Clinic and Internal Medicine Clinic of Alexandria Main University Hospital and Armed Forces Hospital. According to the results of liver biopsy, 36 patients were diagnosed as AIH, one patient as primary biliary cirrhosis [PBC] and the other 3 patients were still undiagnosed. Also, 10 patients with documented diagnosis of non-immune hepatitis B virus in addition to 10 age and sex matched healthy controls were enrolled in this study. Autoantibody profile of ANA, ASMA, AMA, LKM and p-ANCA was measured by indirect immunofluorescent technique [IF] and anti SLA/LP, LKM-1, LC-1 and AMA-M2 autoantibodies were detected by western blot assay. The sensitivity of ANA, ASMA, AMA, LKM, p-ANCA, SLA/LP and LC-1 were 48.6%, 51.4%, 2.7%, 8.1, 56.8%, 18.9% and 10.8% respectively with high specificity [100% for all auto-antibodies except that for ANA 95.7% and ASMA 87%]. However, the overall sensitivity of the complete profile was increased to 100% and specificity was 91.3% from this study we conclude that a complete profile of autoantibodies can be used as a useful tool for the diagnosis of patients with suspected autoimmune liver disease. Anti SLA/LP is an additional specific and diagnostic marker for the diagnosis of AIH type 1 and it remains to be seen whether the seropositivity of SLA/LP may characterize the patients who are more likely to relapse after corticosteroid therapy