Ordering Recommendation

Recommended initial screening panel when autoimmune liver disease is strongly suspected. If negative, less frequently occurring autoantibody tests maybe ordered based on patient’s clinical presentation and history.

Mnemonic
LIVER PAN
Methodology

Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody

Performed

Sun-Sat

Reported

1-8 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 from cells ASAP or within 2 hours of collection. Transfer 0.5 mL serum to an ARUP Standard Transport Tube. (Min: 0.3 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Non-serum, heat-inactivated, contaminated, grossly icteric, severely lipemic, grossly hemolyzed 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

0051174 F-Actin (Smooth Muscle) Antibody, IgG by ELISA with Reflex to Smooth Muscle Antibody, IgG Titer
Test Number
Components
Reference Interval
  F-Actin (Smooth Muscle) Ab, IgG by ELISA Refer to report
0051244 Smooth Muscle Antibody, IgG Titer Refer to report

0055235 Soluble Liver Antigen Antibody, IgG
0.0-20.0 U Negative
20.1-24.9 U Equivocal
Greater than or equal to 25.0 U Positive

0055241 Liver-Kidney Microsome - 1 Antibody, IgG
0.0-20.0 U Negative
20.1-24.9 U Equivocal
25.0 U or greater Positive

3000082 Antinuclear Antibody (ANA) with HEp-2 Substrate, IgG by IFA Less than 1:80

Interpretive Data

Refer to report.

No compliance statements are in use for this test.

Note

If F-Actin, IgG by ELISA is 20 Units or greater, then Smooth Muscle Antibody (SMA), IgG by IFA titer will be added. Additional charges apply.
ANA are determined by indirect fluorescence assay (IFA) using HEp-2 substrate and IgG-specific conjugate at a screening dilution of 1:80. If positive, patterns reported include homogeneous, speckled, centromere, nucleolar, nuclear dots, or cytoplasmic. All positive results are reported with endpoint titers, at no additional charge.

Hotline History
N/A
CPT Codes

86039, 86376, 83516 x3; if reflexed, add 86256

Components
Component Test Code* Component Chart Name LOINC
0050065 Mitochondrial (M2) Antibody, IgG 14251-3
0055235 Soluble Liver Antigen Antibody, IgG 38420-6
0055241 Liver-Kid Microsome-1 Ab, IgG by ELISA 47318-1
0055248 F-Actin (Smooth Muscle) Ab, IgG by ELISA 44706-0
3000090 Antinuclear Antibody (ANA), HEp-2, IgG 21424-7
3000096 ANA Interpretive Comment 49311-4
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
Autoimmune Liver Disease Reflexive Panel