ARUP's Laboratory Test Directory

0055351: Autoimmune Hepatitis Panel Plus with Reflex to Titers

Test Mnemonic: AIH PLUS
Methodology: Enzyme-Linked Immunosorbent Assay/Indirect Fluorescent Antibody

Performed: Sun-Sat

Reported: 2-5 days

Specimen Required:  
Collect: One 4 mL SST.

Transport: 1.5 mL serum at 2-8°C. (Min: 1 mL)  Submit specimen in an ARUP Standard Transport Tube.

Pediatric Collection/Transport: 0.75 mL serum at 2-8°C.

Remarks: Separate serum from cells ASAP. Avoid repeated freeze/thaw cycles.

Stability: After separation from cells: Ambient: 2 days; Refrigerated: 2 weeks; Frozen: 1 year

Reference Interval:
 
Test Number Components Reference Interval
0050080Anti-Nuclear Antibodies (ANA), IgG Screen with Reflex to IFA Titer None detected
0055248F-Actin (Smooth Muscle) Antibody, IgG 19 Units or less: Negative
20-30 Units: Weak Positive - Suggest repeat testing in two to three weeks with fresh specimen.
31 Units or greater: Positive - Suggestive of autoimmune hepatitis or chronic active hepatitis.
0055241Liver-Kidney Microsome - 1 Antibody, IgG 0.0-20.0 U: Negative
20.1-24.9 U: Equivocal
Greater than or equal to 25.0 U: Positive
0050065Mitochondrial M2 Antibody, IgG (ELISA) < 1.0 Units: No antibody detected
1.0-1.3 Units: Inconclusive
> 1.3 Units: Positive
0050811Anti-Neutrophil Cytoplasmic Antibody, IgG < 1:20: Not significant
0055235Soluble 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
 

Note:
Specimens are screened for ANA using ELISA. If antibodies are detected, then an IFA titer using HEp-2 cells will be added.  Specimens are screened for ANCA by IFA on ethanol-fixed slides which allow differentiation of C and P patterns. If screen result is 1:20, then specimens will be serially diluted and tested on ethanol-fixed slides to establish titer and confirm pattern. All P-ANCA patterns are also tested on formalin-fixed slides to confirm P-ANCA by removing ANA receptor sites and maintaining cytoplasmic localization of myeloperoxidase. 

CPT Code(s):
86038 ANA; if reflexed, add 86039 ANA titer; 83516 F-Actin IgG; 86376 LKM-1 IgG; 83516 AMA; 83516 SLA IgG; 86255 ANCA IgG; if reflexed add 86256 if ANCA IgG titer