Liver autoimmune serology: a consensus statement from the committee for autoimmune serology of the International Autoimmune Hepatitis Group

Immunoglobin G4-hepatopathy: Association of immunoglobin G4-bearing plasma cells in liver with autoimmune pancreatitis

“…Patients with AIH were diagnosed as definite according to the scoring system from the International Autoimmune Hepatitis Group, and were classified as having type 1 AIH. 14,15 The diagnosis of PBC was based on internationally accepted criteria, and the antimitochondrial antibody status of each patient was verified. 16 The diagnosis of PSC was NOTE: Anti-SS-A, anti-SS-B, anti-ribonucleoprotein, and antimitochondrial antibody-M2 were all negative in 15 cases.…”

Brazilian society of hepatology recommendations for the diagnosis and management of autoimmune diseases of the liver

“…Other French study, evaluating treatment response of 17 patients with AIH-PBC overlap AIH/PBC with either UDCA (n=11) or UDCA+IS (n=6) followed for 7,3 years, have observed more frequent biochemical response and less fibrosis progression in the group of patients with combined UDCA+IS (184) . Distinct results were reported in another study (15) which disclosed no difference in the treatment of those patients either with UDCA or with UDCA+IS (185) . A recent meta-analysis, however, showed more biochemical and histological improvement in subjects treated with UDCA+IS when comared to those treated with UDCA alone (186) .…”

“…ANA, ASMA, anti-LKM1 are the classical AA used to diagnose and classify AIH. They are tested by indirect immunofluorescence (IFI) using tissue sections of kidney, liver and stomach of rodents as a substrate (15) . Titers of AA in general do not correlate with severity of disease and its clinical course.…”

“…According to international criteria, AA titers are considered positive, when present at a dilution of at least 1:40 in adults, while titers of at least 1:20 for SMA and ANA or titers of at least 1:10 for anti-LKM1 are considered positive in children (17) . Homogeneous and speckled are the most frequent patterns of ANA in AIH patients (11,13,15,18) . Centromeric, nucleolar and nuclear dots cannot be considered as markers of AIH.…”

“…The specificity for antigens present in the microfilaments (F-actin), characterizing anti-actin antibody (AAA) is specific, but not pathognomonic, of AIH and is well correlated with the presence of SMA-VGT pattern in IIF (21) . Lack of IFI standardization limits its use on routine basis (13,15) Usually, patients with reactivity for SMA are younger than patients with reactivity for ANA. In this regard, patients with AIH-1 and SMA also exhibit reactivity for AAA and are shown to carry HLA-DR13 and -DR3 genotypes in South America and HLA-DR3 and -DR4 in Europe and North-America.…”