Autoimmune Liver Disease Evaluation with Reflex to Smooth Muscle Antibody (SMA), IgG by IFA
2007210
Ordering Recommendation
Recommended first-line panel for the evaluation of autoimmune liver disease (ALD). Negative results do not rule out disease.
Mnemonic
LIVER EVAL
Methodology
Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody
Performed
Refer to individual components
Reported
1-4 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
ARUP Consult®
Disease Topics
Specimen Required
- Patient Preparation
- Collect
- Serum separator tube (SST).
- Specimen Preparation
- Separate serum from cells ASAP or within 2 hours of collection. Transfer 1.0 mL serum to an ARUP Standard Transport Tube. (Min: 0.6 mL)
- Storage/Transport Temperature
- Refrigerated.
- Unacceptable Conditions
- Non-serum specimens. Contaminated, heat-inactivated, grossly hemolyzed, grossly icteric, severely lipemic specimens or inclusion of fibrin clot.
- Remarks
- Stability
- After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
Reference Interval
| Test Number | Components | Reference Interval |
|---|---|---|
| 0050065 | Mitochondrial M2 Antibody, IgG (ELISA) | 20.0 Units or less: Negative 20.1-24.9 Units: Equivocal 25.0 Units or greater: Positive |
| 0055241 | Liver-Kidney Microsome - 1 Antibody, IgG | 0.0-20.0 U: Negative 20.1-24.9 U: Equivocal Greater than or equal to 25.0 U: Positive |
| 0055248 | F-Actin (Smooth Muscle) Antibody, IgG | 19 Units or less: Negative 20-30 Units: Weak Positive - Suggest repeat testing in two to three weeks with fresh specimen 31 Units or greater: Positive - Suggestive of autoimmune hepatitis type 1 or chronic active hepatitis |
| Smooth Muscle Antibody, IgG Titer | <1:20 Normal - No antibody detected 1:20-1:80 Weak Positive - Suggest repeat testing in two to three weeks with fresh specimen 1:160 or greater Positive - Suggestive of autoimmune hepatitis or chronic active hepatitis |
Interpretive Data
F-Actin Antibody, IgG by ELISA:F-actin antibodies have been shown to have greater sensitivity and specificity for autoimmune liver disease than anti-smooth muscle antibodies.
Liver-Kidney Microsome-1 Antibody, IgG by ELISA: A positive result indicates the presence of IgG antibodies to recombinant human P450 2D6 and suggests the possibility of autoimmune hepatitis, type 2. A negative LKM-1 does not rule out the presence of autoimmune hepatitis, type 2.
Liver-Kidney Microsome-1 Antibody, IgG by ELISA: A positive result indicates the presence of IgG antibodies to recombinant human P450 2D6 and suggests the possibility of autoimmune hepatitis, type 2. A negative LKM-1 does not rule out the presence of autoimmune hepatitis, type 2.
Note
If F-Actin, IgG result is 20 Units or greater, then Smooth Muscle Antibody, IgG titer will be added. Additional charges apply.
CPT Code(s)
83516 x2; 86376; if reflexed, add 86256
Components
| Component Test Code* | Component Chart Name | LOINC |
|---|---|---|
| 0050065 | Mitochondrial (M2) Antibody, IgG | 14251-3 |
| 0055241 | Liver-Kid Microsome-1 Ab, IgG by ELISA | 47318-1 |
| 0055248 | F-Actin (Smooth Muscle) Ab, IgG by ELISA | 44706-0 |
Aliases
- AMA M2
- anti-M2
- Antinuclear Antibodies, Serum
- F Actin
- F-actin
- F-Actin (Smooth Muscle) Antibody, IgG
- Liver-Kidney Microsome-1 Antibody, IgG
- LKM1 IgG
- Mito M2
- Mitochondrial Antibodies, Serum
- Mitochondrial M2 Antibody, IgG (ELISA)
- SMA
- SMA Titer
- Smooth Muscle Antibodies, Serum
- Smooth Muscle Antibody, IgG Titer