Autoimmune liver disease antibodies
Reading ANA, smooth muscle (F-actin), anti-LKM1, anti-LC1, anti-SLA, AMA (M2) and the PBC-specific ANA (sp100, gp210) with IgG and IgM, how immunofluorescence patterns and titres feed the simplified AIH score and PBC criteria, and the low-titre and look-alike results that mislead.
Tier 2Medical sciences concept
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Liver autoantibodies support a diagnosis of autoimmune hepatitis (AIH) or primary biliary cholangitis (PBC). They don't prove AIH, and about 10% of AIH is seronegative.
- Indirect immunofluorescence (IIF) on rodent liver, kidney and stomach is the reference method for AIH antibodies (IAIHG 2004, Galaski 2021). HEp-2 cells give the ANA pattern. ELISA or line blots confirm specific targets.
- Read antibodies with IgG (raised in AIH) and IgM (raised in PBC), the LFT pattern and drugs.
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Sources
- EASL Clinical Practice Guidelines on the management of autoimmune hepatitis. J Hepatol 2025;83:453-501European Association for the Study of the Liver, 2025
- Mack CL et al. Diagnosis and management of autoimmune hepatitis in adults and children: 2019 practice guidance and guidelines from the American Association for the Study of Liver Diseases. Hepatology 2020;72:671-722American Association for the Study of Liver Diseases, 2019 (no newer AASLD AIH guidance found November 2026)
- Gleeson D et al. British Society of Gastroenterology guidelines for diagnosis and management of autoimmune hepatitis. Gut 2025;74:1364-1409British Society of Gastroenterology, 2025
- Levy C et al. AGA/AASLD Clinical Practice Guideline on Management of Primary Biliary Cholangitis. Gastroenterology 2026;171:817-39American Gastroenterological Association and American Association for the Study of Liver Diseases, 2026
- Vergani D et al. Liver autoimmune serology: a consensus statement from the committee for autoimmune serology of the International Autoimmune Hepatitis Group. J Hepatol 2004;41:677-83International Autoimmune Hepatitis Group, 2004
- Galaski J et al. Update of the simplified criteria for autoimmune hepatitis: evaluation of the methodology for immunoserological testing. J Hepatol 2021;74:312-20Journal of Hepatology, 2021
- RCPA Manual (liver autoantibodies, mitochondrial antibodies)AU/NZRoyal College of Pathologists of Australasia
- Last updated
- 14 November 2026
What changed
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