Antibodies to soluble liver antigen in patients with various liver diseases: A multicentre study

被引:36
作者
Efe, Cumali [1 ]
Ozaslan, Ersan [1 ]
Wahlin, Staffan [2 ]
Purnak, Tugrul [1 ]
Muratori, Luigi [3 ]
Quarneti, Chiara [3 ]
Yuksel, Osman [4 ]
Muratori, Paolo [3 ]
机构
[1] Numune Res & Educ Hosp, Dept Gastroenterol, Ankara, Turkey
[2] Karolinska Univ Hosp, Karolinska Inst, Dept Gastroenterol & Hepatol, Stockholm, Sweden
[3] Univ Bologna, Dept Clin Med, Bologna, Italy
[4] Ankara Diskapi Educ & Res Hosp, Dept Gastroenterol, Ankara, Turkey
关键词
auto-antibody; Autoimmune hepatitis; hepatitis B virus; hepatitis C virus; non-alcoholic steatohepatitis; overlap syndrome; primary biliary cirrhosis; primary sclerosing cholangitis; soluble liver antigen; PRIMARY BILIARY-CIRRHOSIS; AUTOIMMUNE HEPATITIS; OVERLAP SYNDROME; AUTOANTIBODIES; DIAGNOSIS; PANCREAS; INJURY; ESTABLISHMENT; MANAGEMENT;
D O I
10.1111/liv.12022
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background Antibodies to soluble liver antigen (anti-SLA) are specific serological markers of autoimmune hepatitis (AIH). The clinical significance and frequency of anti-SLA have never been reported among AIH patients from Italy and Turkey. To retrospectively assess the estimated prevalence, sensitivity, specificity and clinical significance of anti-SLA in AIH and various liver diseases. Methods A total of 986 patients who had been tested for serum anti-SLA were included in study. The presence of anti-SLA was detected using recombinant enzyme linked immunosorbent assay and immuno-blot. The general characteristics and outcome of patients were obtained from their medical records. Results Antibodies to SLA were found in 30 (3%) of 986 patients. Of these, 27 (90%) had AIH and its variants, whereas the remaining three (10%) had primary biliary cirrhosis. The prevalence of anti-SLA was 9% in AIH patients from Italy and 15% in patients from Turkey. The specificity of these antibodies was 99.5%, whereas sensitivity was 11%. The positive predictive and negative predictive values were 90% and 77.5% respectively (95% confidence interval). Biochemical remission was achieved in 90% of anti-SLA positive AIH patients, but relapse after immunosuppressive withdrawal or during maintenance therapy was observed in 53% of the patients. Conclusions Seropositivity for anti-SLA occurs at similar frequencies in AIH patients from different geographical regions and ethnic groups. The sensitivity of anti-SLA is low, but it has high specificity for AIH. Additional studies are necessary to prove clinical significance of anti-SLA in AIH.
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页码:190 / 196
页数:7
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