Diagnostic Role of Specific Liver Autoantibodies In Autoimmune Liver Diseases

Abstract

Background:Autoimmune liver diseases (AILD) are part of a spectrum of autoimmune diseases primarily involving the liver and include autoimmune hepatitis (AIH), primary biliary cirrhosis (PBC), and primary sclerosing cholangitis (PSC). These diseases usually occur in isolation but sometimes their features may overlap, which is a distinct entity with different therapy known as overlap syndrome.Autoimmune hepatitis (AIH) is a chronic inflammatory condition of the liver due to an autoimmune attack against hepatocytes. AIH is characterized clinically by female preponderance and variable presentation, biochemically by high serum levels of transaminases, serologically by elevated immunoglobulin G (IgG) and positive circulating autoantibodies, and histologically by interface hepatitis. A key diagnostic criterion for all AIH scoring systems is the detection of autoantibodies, which not only assists in the diagnosis but also allows differentiation of AIH types. ANA and SMA characterize AIH-1, while anti-LKM-1 and anti-LC-1 define AIH-2, though occasionally ANA or SMA can coexist with anti-LKM-1 or anti-LC-1, the clinical course in these cases being similar to that of AIH-2