Autoimmune Liver Disease Evaluation with Reflex to Smooth Muscle Antibody (SMA), IgG by IFA
2007210
 
Ordering Recommendation
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.
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.
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
0050065Mitochondrial (M2) Antibody, IgG
0055241Liver-Kid Microsome-1 Ab, IgG by ELISA
0055248F-Actin (Smooth Muscle) Ab, IgG by ELISA
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, contact interface support at interface.support@aruplab.com.
Cross References
  • 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