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What in the world is anti-smooth muscle antibody (SMA)!?
Join me for another quick-hit #livertwitter #tweetorial on this mysterious test used in the eval of autoimmune hepatitis
Second in a series on diagnostic testing for liver disease #meded
Join me for another quick-hit #livertwitter #tweetorial on this mysterious test used in the eval of autoimmune hepatitis
Second in a series on diagnostic testing for liver disease #meded
Autoimmune hepatitis is:
1⃣Rare, 2/100,000; higher with age.(Fig1)
2⃣Causes <1.8% of persistently elevated liver enzymes(Fig2)
3⃣Suggested by positive antibodies but best dx by biopsy. 👀diag criteria,Fig3
*nb: talking about Type1 AIH
1⃣Rare, 2/100,000; higher with age.(Fig1)
2⃣Causes <1.8% of persistently elevated liver enzymes(Fig2)
3⃣Suggested by positive antibodies but best dx by biopsy. 👀diag criteria,Fig3
*nb: talking about Type1 AIH
ASMA: Technical facts
1⃣An immunofluor test. Patient serum exposed to, u guessed it, rat gut!(Fig1)
2⃣Reacts w/cytoskeletal elements (e.g. F-actin) incl glomeruli(Fig2)
3⃣Assay=Very operator dependent.
4⃣Can also ID ab to parietal cells, AMA & ANA(Fig3)
1⃣An immunofluor test. Patient serum exposed to, u guessed it, rat gut!(Fig1)
2⃣Reacts w/cytoskeletal elements (e.g. F-actin) incl glomeruli(Fig2)
3⃣Assay=Very operator dependent.
4⃣Can also ID ab to parietal cells, AMA & ANA(Fig3)
To summarize
👉Autoimmune hepatitis is a rare but important diagnosis
👉Antismooth muscle ab (ASMA) is more likely to be found in people without AIH than those with it. Including those w/NASH
👉ASMA doesn't diagnose AIH; it's a piece of the AIH-1 puzzle
👉ASMA is a finnicky test
👉Autoimmune hepatitis is a rare but important diagnosis
👉Antismooth muscle ab (ASMA) is more likely to be found in people without AIH than those with it. Including those w/NASH
👉ASMA doesn't diagnose AIH; it's a piece of the AIH-1 puzzle
👉ASMA is a finnicky test
This concludes my second short #tweetorial on diagnostic testing in liver disease. I hope you enjoyed it. The next (and last?) will be on ceruloplasmin. Please stay tuned!
