Liver-Kidney Microsome Antibody, IgG


Sunquest Code:LKAB  
Epic Code:LAB3588Epic Name:LIVER KIDNEY MICROSOMAL ANTIBODY IGG
Methodology:Indirect fluorescent antibody
CPT Code:86376
Turnaround Time:Specimens are sent to reference laboratory Mon-Sat; results are reported in 1-5 days.
Compliance:

This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.



Collection Instructions

Specimen:Blood
Optimal Volume:2 mL
Minimum\Peds Volume:0.5 mL
Container:Red or gold (gel) (Red (no gel))
Causes for Rejection:Severely hemolyzed, severely lipemic


Processing and Shipping

Specimen Processing:Centrifuge and aliquot 1 mL, 0.15 mL minimum. Samples are stable refrigerated for 2 weeks.
Shipping Instructions:Ship on dry ice.
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:99270 (LIVER-KID)


Interpretive

Reference Range:Less than 1:20 Normal
Use:

Autoimmune hepatitis (AIH) is chronic inflammatory liver disease, characterized by the presence of antibodies against microsomal antigens expressed within hepatocytes. AIH can be categorized into three separate disease groups based on the presence of marker autoantibodies in the serum of affected patients. AIH Type 1, the more common (60-70%), is characterized by the presence of autoantiodies against nuclear (ANA) and smooth muscle (ASM) antigens. AIH Type 2, which is less prevalent with only 10-20 cases per million, has an acute onset with a rapid progression to cirrhosis and liver failure. AIH Type 2 is characterized by the presence of specific antibodies (LKM-1) against LKM antigens (cytochrome P450IID6) and the absence of ANA and ASM. AIH Type 3 is characterized by the presence of autoantibodies against soluble liver antigens (SLA) which react with liver cytokeratins.

 

LKM-1 antibody reacts uniformly with cytochrome P450IID6, a 50 kDa protein found in the cytoplasm of all hepatocytes and renal proximal tubular cells. Studies in the early 1990s identified <3% of patients infected with hepatitis C virus have related antibodies that also recognize antigenic sites on P450IID6. LKM-2 antibody is associated with ticrynafen (tienilic acid) induced hepatitis. The target antigen for this antibody is cytochrome P450IIC9.

 

Although the specific LKM antigenic sites differ from one another, LKM-1 and LKM-2 antibodies cannot be differentiated using indirect fluorescent antibody (IFA) techniques.

 



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