Significance of antibodies to soluble liver antigen/liver pancreas: a large French study.
BACKGROUND
Antibodies to soluble liver antigen (SLA)/liver pancreas (LP) are generally considered as highly specific diagnostic markers of type 1 auto-immune hepatitis (AIH-1), and are particularly useful in patients without conventional antibodies. However, the presence of anti-SLA/LP in type 2 auto-immune hepatitis (AIH-2), primary sclerosing cholangitis (PSC) and hepatitis C has recently been reported. The aim was thus to describe the characteristics of anti-SLA/LP-positive patients in the largest series reported to date.


METHODS
Sera were selected from the period between 1998 and 2005, based on the presence of antibodies to SLA/LP detected by two methods. The clinical status of patients was determined from their medical records.


RESULTS
Eighty-one anti-SLA/LP-positive patients with available clinical data were included: 89% (72/81) had a diagnosis of AIH-1, including 10 (12%) associated with cholestatic diseases (primary biliary cirrhosis in seven cases and PSC in three cases). Six patients (7%) suffered from another liver disease: hepatitis C (n=3) and drug-induced hepatitis (n=3). No specific diagnosis was made in three patients.


CONCLUSIONS
Antibodies to SLA/LP are of a major diagnostic value for AIH-1, including paediatric forms and overlap syndromes with cholestatic diseases, but are not found in association with anti-liver/kidney/microsome type 1 or antibodies to liver cytosol type 1. They are rarely present in other liver diseases such as hepatitis C and drug-induced hepatitis.
Eyraud
Violaine
V
AP-HP Hôpital Saint-Antoine, Unité d'Immunologie, Paris, France.
Chazouilleres
Olivier
O
Ballot
Eric
E
Corpechot
Christophe
C
Poupon
Raoul
R
Johanet
Catherine
C
D000906:Antibodies / Q000097:blood / Q000276:immunology*; D001324:Autoantigens / Q000276:immunology*; D001649:Bile Duct Diseases / Q000175:diagnosis* / Q000276:immunology; D015415:Biomarkers / Q000097:blood*; D015153:Blotting, Western; D004591:Electrophoresis, Polyacrylamide Gel; D004797:Enzyme-Linked Immunosorbent Assay; D005602:France; D019693:Hepatitis, Autoimmune / Q000175:diagnosis* / Q000276:immunology; D006801:Humans; D012189:Retrospective Studies
D000906:Antibodies; D001324:Autoantigens; D015415:Biomarkers; C046431:liver antigen LA-1