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[The significance of anti-soluble liver antigen/liver-pancreas in diagnosing and typing autoimmune hepatitis].

Yan Zhao, Huiping Yan, Yu‐fen Tan, Xia Feng, Yan Liu, Dan Cui, Dong-mei Ma, Weihua Li, Haiping Zhang

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Abstract

OBJECTIVE: To study the significance of anti-soluble liver antigen/liver-pancreas (anti-SLA/LP) in diagnosing and typing autoimmune hepatitis (AIH). METHODS: Six thousand patients with abnormal liver functions, who had their autoantibodies checked by immunofluorescent assay (IFA) and immune blotting assay, were reviewed retrospectively. RESULTS: Of these 6000 patients with liver diseases, 84 were diagnosed AIH. Eighteen patients, 0.3% of the 6000, patients with abnormal liver functions, were SLA/LP antibody positive, of which 17 were with AIH-III [2/17 with AIH /primary biliary cirrhosis (PBC) overlap syndrome], and 1 with chronic hepatitis B. Sensitivity and specificity of SLA/LP antibody in diagnosing AIH were 20.2% and 99.7% respectively, and the positive prediction value was 94.44%. The antinuclear antibody (ANA) titer in the AIH-III group was significantly lower than that of the AIH-I group (P < 0.05). The age of patients with anti-SLA/LP was higher (58.8% were over 50 years old) than those without this antibody (52.2% were 30 to 50 years old). There were no significant differences between the type III and type I AIH regarding gender, age, abnormal degree of liver function, PTA, IgG, liver cirrhosis rates and response to immunosuppressive therapy. CONCLUSION: Anti-SLA/LP is highly specific for diagnosing AIH. Comparing the clinical data of type III and type I AIH, we did not find significant differences between the two groups.

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OBJECTIVE: To study the significance of anti-soluble liver antigen/liver-pancreas (anti-SLA/LP) in diagnosing and typing autoimmune hepatitis (AIH). METHODS: Six thousand patients with abnormal liver functions, who had their autoantibodies checked by immunofluorescent assay (IFA) and immune blotting assay, were reviewed retrospectively. RESULTS: Of these 6000 patients with liver diseases, 84 were diagnosed AIH. Eighteen patients, 0.3% of the 6000, patients with abnormal liver functions, were SLA/LP antibody positive, of which 17 were with AIH-III [2/17 with AIH /primary biliary cirrhosis (PBC) overlap syndrome], and 1 with chronic hepatitis B. Sensitivity and specificity of SLA/LP antibody in diagnosing AIH were 20.2% and 99.7% respectively, and the positive prediction value was 94.44%. The antinuclear antibody (ANA) titer in the AIH-III group was significantly lower than that of the AIH-I group (P < 0.05). The age of patients with anti-SLA/LP was higher (58.8% were over 50 years old) than those without this antibody (52.2% were 30 to 50 years old). There were no significant differences between the type III and type I AIH regarding gender, age, abnormal degree of liver function, PTA, IgG, liver cirrhosis rates and response to immunosuppressive therapy. CONCLUSION: Anti-SLA/LP is highly specific for diagnosing AIH. Comparing the clinical data of type III and type I AIH, we did not find significant differences between the two groups.

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Available abstract

OBJECTIVE: To study the significance of anti-soluble liver antigen/liver-pancreas (anti-SLA/LP) in diagnosing and typing autoimmune hepatitis (AIH). METHODS: Six thousand patients with abnormal liver functions, who had their autoantibodies checked by immunofluorescent assay (IFA) and immune blotting assay, were reviewed retrospectively. RESULTS: Of these 6000 patients with liver diseases, 84 were diagnosed AIH. Eighteen patients, 0.3% of the 6000, patients with abnormal liver functions, were SLA/LP antibody positive, of which 17 were with AIH-III [2/17 with AIH /primary biliary cirrhosis (PBC) overlap syndrome], and 1 with chronic hepatitis B. Sensitivity and specificity of SLA/LP antibody in diagnosing AIH were 20.2% and 99.7% respectively, and the positive prediction value was 94.44%. The antinuclear antibody (ANA) titer in the AIH-III group was significantly lower than that of the AIH-I group (P < 0.05). The age of patients with anti-SLA/LP was higher (58.8% were over 50 years old) than those without this antibody (52.2% were 30 to 50 years old). There were no significant differences between the type III and type I AIH regarding gender, age, abnormal degree of liver function, PTA, IgG, liver cirrhosis rates and response to immunosuppressive therapy. CONCLUSION: Anti-SLA/LP is highly specific for diagnosing AIH. Comparing the clinical data of type III and type I AIH, we did not find significant differences between the two groups.

Key concepts: Autoimmune hepatitis, Medicine, Autoantibody, Overlap syndrome, Anti-nuclear antibody, Gastroenterology, Internal medicine, Cirrhosis

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