[A retrospective study on the role of antibodies against soluble liver antigen (anti-SLA antibodies) and other autoantibodies in the diagnostics of autoimmune hepatitis].
OBJECTIVE
To determine the diagnostic value of antibodies against soluble liver antigen (anti-SLA antibodies) and a number of other antibodies for the diagnosis ofautoimmune hepatitis (AIH).


METHODS
Retrospective.


METHODS
Anti-SLA, antinuclear antibodies (ANA), antibodies against smooth muscle (anti-SMA), anti-neutrophil cytoplasm antibodies (peri-nuclear pattern; pANCA) and antibodies against liver-kidney microsomal antigen type 1 (anti-LKM-1) were determined in the sera of 97 patients with AIH and 121 patients with other liver disorders including viral, drug-related and alcoholic liver disease. The sensitivity and specificity of each of the antibodies, or a combination ofantibodies, were calculated for the diagnosis 'AIH'.


RESULTS
Anti-SLA antibodies were found only in AIH patients (specificity: 100%); 1 in 7 AIH patients (14%) had these antibodies and in 2% they were the only detectable antibodies. Anti-LKM-1 antibodies also showed a 100% specificity for AIH although the sensitivity was much lower (2%). Whilst the sensitivity of ANA (53%), pANCA (39%) and SMA (39%) was higher, the specificity of these antibodies for AIH was lower. 20% of AIH patients tested negative for all autoantibodies. The simultaneous presence of more than one antibody increased the probability of AIH diagnosis.


CONCLUSIONS
When AIH is suspected, the presence of one or a combination ofanti-SLA, ANA, anti-SMA, anti-LKM-1 and pANCA antibodies is helpful for the often difficult differential diagnosis between AIH and other liver disorders. Anti-SLA antibodies are specific for AIH and appear to be a useful diagnostic parameter.
Bakker-Jonges
L E
LE
Erasmus MC, Dr.Molewaterplein 50, 3015 GE Rotterdam. l.e.bakker@erasmusmc.nl
ter Borg
P C J
PC
van Buuren
H R
HR
Hooijkaas
H
H
D001323:Autoantibodies / Q000097:blood*; D001324:Autoantigens / Q000276:immunology*; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D019693:Hepatitis, Autoimmune / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D008099:Liver / Q000276:immunology; D008297:Male; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
D001323:Autoantibodies; D001324:Autoantigens; D015415:Biomarkers; C046431:liver antigen LA-1