Evaluación del panel de enfermedades hepáticas autoinmunes (INMUNOBLOT) en el diagnóstico de enfermedades hepáticas
Utility of the detection of autoantibodies in autoinmune liver diseases using immunoblot
Rev. méd. Chile; 151 (4), 2023
Publication year: 2023
INTRODUCTION:
For the diagnosis of liver diseases, clinical criteria, biochemical, immunological and histological parameters are included. The autoimmune panel is an immunoblot that contemplates the detection of antibodies against 9 different hepatic antigens, which could guide the diagnosis of these pathologies.OBJECTIVE:
To describe the usefulness of the autoimmune panel in the diagnosis of liver diseases.Methods:
Observational, descriptive study. All autoimmune panels performed between January 2020 and August 2021 (n = 279) were reviewed, and the ones with positive result selected (n = 101). Clinical records were reviewed, including: clinical, biochemical, immunological and histological characteristics. Diagnosis was determined by clinical suspicion (clinical, biochemical and immunological parameters), only through autoimmune panel, and according to liver biopsy in available cases.RESULTS:
45 patients with complete clinical history were included in the analysis; 82% women, median age 58 years (16-79). Clinical suspicions included autoimmune hepatitis (AIH) in 12 patients (27%), primary biliary cholangitis (PBC) in 10 patients (22%), overlap syndrome (AIH/PBC) in 17 (38%), and others in 6 (13%). The diagnosis of PBC was confirmed by autoimmune panel in 9/10 and 11/17 patients with clinical suspicion of PBC and HAI/PBC, respectively. Of the 27 patients with initial clinical suspicion of PBC, 14 had negative AMA and AMA-M2 (6 had Sp100 and 5 gp210 as the only markers and 3 had positive Sp100 and PML). In 10/14 patients, the diagnosis was confirmed by panel and/or compatible liver biopsy.CONCLUSION:
The autoimmune panel turns out to be a useful diagnostic tool for liver diseases, especially PBC in isolation or in overlap syndrome.
Autoanticuerpos/sangre, Enfermedades Autoinmunes/sangre, Enfermedades Autoinmunes/diagnóstico, Enfermedades Autoinmunes/inmunología, Hepatitis Autoinmune/sangre, Hepatitis Autoinmune/diagnóstico, Hepatitis Autoinmune/inmunología, Immunoblotting/métodos, Cirrosis Hepática Biliar/sangre, Cirrosis Hepática Biliar/diagnóstico, Cirrosis Hepática Biliar/inmunología, Hepatopatías/diagnóstico, Hepatopatías/inmunología