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What is Liver-Kidney Microsome (LKM)-1 Antibody test? 

LKM-1 antibodies are autoantibodies that attack the liver cells, causing damage to the organ.

Antibodies are special proteins normally produced by the immune system to fight harmful foreign substances. Autoantibodies, on the other hand, are antibodies mistakenly produced by the immune system against body’s own cells and tissues, leading to autoimmune diseases. 

The LKM-1 autoantibodies are produced in response to a specific protein in the liver known as cytochrome P450 2D6 (CYP2D6). Presence of these autoantibodies in the blood is strongly associated with a condition known as type 2 autoimmune hepatitis. 

Autoimmune hepatitis is a prolonged inflammatory liver disease associated with symptoms such as muscle ache, abdominal discomfort, jaundice and an enlarged liver. Depending on the type of autoantibodies produced, there are two types of autoimmune hepatitis - type 1 and type 2.

A person with type 1 autoimmune hepatitis has smooth muscle antibodies (SMA) - antibodies that attack the smooth muscles - in their blood. It can affect anyone but is more prevalent in young women. Most individuals with type 1 autoimmune hepatitis also have another autoimmune condition, such as type 1 diabetes or ulcerative colitis

Type 2 autoimmune hepatitis is associated with the presence of LKM-1 antibodies. This disease may affect adults but is commonly seen in girls aged two to 14 years. 

Autoimmune hepatitis may lead to complications such as liver cirrhosis and liver failure.

  1. Why is a Liver-Kidney Microsome (LKM)-1 Antibody test performed?
  2. How do you prepare for a Liver-Kidney Microsome (LKM)-1 Antibody test?
  3. How is a Liver-Kidney Microsome (LKM)-1 Antibody test performed?
  4. Liver-Kidney Microsome (LKM)-1 Antibody test results and normal range

Your doctor may order this test to check for autoimmune hepatitis if you show symptoms of liver disease and have abnormal results on routine liver tests.

The symptoms of autoimmune hepatitis include:

In advanced autoimmune hepatitis, additional symptoms such as mental confusion and fluid build-up in the abdomen may occur.

However, these symptoms are not exclusive to autoimmune hepatitis and may be seen in other liver conditions

An LKM-1 antibody test is usually done along with an SMA test to distinguish between type 1 and type 2 autoimmune hepatitis.

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No prior preparations are needed for this test. However, please make sure that you inform your doctor if you are taking any routine medications or health supplements.

A healthcare practitioner will withdraw a sample of your blood from a vein in your arm. You may feel a mild pricking sensation when the needle is inserted. Some people also get a small bruise at the site of needle insertion. Though in most cases the bruise heals on its own in a few days.

If you get nervous about blood tests, please convey this to your doctor or nurse so that they can make you feel more comfortable during the test.

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Normal results:

A negative result is reported as normal. 

A normal or negative result for this test is ≤ 20.0 Units.

A negative result indicates that no LKM-1 antibodies were found in your blood. However, further testing may be needed to rule out autoimmune hepatitis. Please speak to your doctor to know what exactly your results mean for you.

Abnormal results:

A value ≥ 25.0 Units is considered as positive or abnormal.

A positive result means that LKM-1 antibodies were found in the blood and is indicative of type 2 autoimmune hepatitis. The doctor may conduct a liver biopsy to confirm the diagnosis.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.

References

  1. Bogdanos, DP, Invernizzi. Autoimmune Liver serology: Current Diagnostic and Clinical Challenges. World Journal of Gastroenterology, Vol 14: 3374-3387. PMID: 18528935
  2. European Association for the Study of the Liver. EASL Clinical Practice Guidelines: Autoimmune hepatitis.. J Hepatol. 2015 Oct;63(4):971-1004. doi: 10.1016/j.jhep.2015.06.030. Epub 2015 Sep 1.
  3. Czaja, AJ. Diagnosis and management of autoimmune hepatitis: current status future directions. Gut and Liver, Vol 10: 177-203. PMID: 26934884
  4. Narciso- Schiavon. To screen or not to screen? Celiac antibodies in liver diseases. World Journal of Gastroenterology. Vol 23: 776- 791. PMID: 28223722
  5. Himito T. Nishioko M. Auto antibodies in liver disease- Important clues for diagnosis, disease activity and prognosis. Auto Immun Highlights. 2013 Aug; 4(2): 39–53. PMID: 26000142
  6. ARUP Labs [Internet]. University of Utah. Liver-Kidney Microsome Antibody, IgG
  7. American Liver Foundation [internet]. New York (NY): American Association for the Study of Liver Diseases; Autoimmune Hepatitis
  8. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; Liver Kidney Microsomal Antibody
  9. National Health Service [internet]. UK; Blood Tests
  10. University of Iowa. Department of Pathology. Laboratory Services Handbook [internet]. Liver-Kidney Microsome Antibody, IgG
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