ARUP's Laboratory Test Directory

Autoimmune Liver Disease Evaluation with Reflex to Smooth Muscle Antibody (SMA), IgG by IFA : 2007210
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Additional Technical Information
  


Mnemonic: LIVER EVAL

Methodology: Semi-Quantitative Enzyme-Linked Immunosorbent Assay/Semi-Quantitative Indirect Fluorescent Antibody
Performed: Refer to individual components
Reported: 1-4 days
Specimen Required: Collect: Serum separator tube (SST).

Specimen Preparation: Separate serum from cells ASAP or within 2 hours of collection. Transfer 1.0 mL serum to an ARUP Standard Transport Tube. (Min: 0.6 mL)

Storage/Transport Temperature: Refrigerated.

Unacceptable Conditions: Non-serum specimens. Contaminated, heat-inactivated, grossly hemolyzed, grossly icteric, severely lipemic specimens or inclusion of fibrin clot.

Stability (collection to initiation of testing): After separation from cells: Ambient: 48 hours; Refrigerated: 2 weeks; Frozen: 1 year (avoid repeated freeze/thaw cycles)
Reference Interval:
 
Test Number Components Reference Interval
0050065 Mitochondrial M2 Antibody, IgG (ELISA) 20.0 Units or less: Negative
20.1-24.9 Units:  Equivocal
25.0 Units or greater: Positive
0055241 Liver-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
0055248 F-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 type 1 or chronic active hepatitis
 Smooth Muscle Antibody, IgG Titer <1:20  Normal - No antibody detected
1:20-1:80  Weak Positive - Suggest repeat testing in two to three weeks with fresh specimen
1:160 or greater  Positive - Suggestive of autoimmune hepatitis or chronic active hepatitis

Interpretive Data: F-Actin Antibody, IgG by ELISA: F-actin antibodies have been shown to have greater sensitivity and specificity for autoimmune liver disease than anti-smooth muscle antibodies.

Liver-Kidney Microsome - 1 Antibody, IgG by ELISA: A positive result indicates the presence of IgG antibodies to recombinant human P450 2D6 and suggests the possibility of autoimmune hepatitis, type 2. A negative LKM-1 does not rule out the presence of autoimmune hepatitis, type 2.
Note: If F-Actin, IgG result is 20 Units or greater, then Smooth Muscle Antibody, IgG titer will be added. Additional charges apply.
CPT Code(s): 83516 x2; 86376; if reflexed, add 86256
Cross References: Autoimmune Hepatitis (AIH) (Autoimmune Liver Disease Evaluation with Reflex to Smooth Muscle Antibod , Primary Biliary Cirrhosis (PBC) (Autoimmune Liver Disease Evaluation with Reflex to Smooth Muscle An