Engelsk titel: Autoantibodies of importance for diagnosis
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Författare:
Dahle, Charlotte
Email: charlotte.dahle@lio.se
Språk: Swe
Antal referenser: 16
Dokumenttyp:
Översikt
UI-nummer: 10061156
Sammanfattning
Immunofluorescence (IF) microscopy on rat tissue cryosections has long been the gold standard to detect antibodies against smooth muscle (SMA), 'liver kidney microscomal antigen' (LKM-1), and mitochondrial antigens (AMA), i.e. markers of autoimmune hepatitis (AIH) type 1 & 2, and primary biliary cirrhosis (PBC), respectively. Since IF-staining patterns may be difficult to interpret, and several important antibody specificities are not detected by IF-microscopy, antigen-specific tests should also be included in diagnostic routine. For example, antibodies against 'soluble liver antigen' (SLA) is a strong marker of AIH. Anti-SLA has been reported to occur without concomitant SMA in about 10% of AIH and in 20% of cases with acute liver failure of unknown reason, indicating that the diagnosis has been foreseen until end-stage. Another crucial issue regards cut-off limits for positive IF-micoscopy tests. This must be determined locally at every diagnostic laboratory using control sera from healthy persons. Antibody titres cannot be directly compared between laboratories!