Autoimmune Liver Disease Panel
Label Mnemonic: ALDP
Epic code: LAB8698
Order form: Laboratory Requisition
Supply order: Supply Order Form
Billing: Billing Policies
CPT code: 83516 x1, 86038 x1, 86255 x1
86256-Smooth Muscle Antibodies Titer (if appropriate)
Specimen(s):
Serum
Collection Medium:
Red top tube 5 mL (Clot Activator)
Minimum:
Preferred Minimum: 1.5 mL Serum
Absolute Minimum: 1.0 mL Serum
Testing Schedule:
Monday through Friday; 9 am and 4 pm, Saturday; 12 pm
Turn Around Time:
3 days upon receipt at reference laboratory
Reference Range:
SMOOTH MUSCLE ANTIBODIES
Negative
If positive, results are titered.
Reference values apply to all ages

MITOCHONDRIAL ANTIBODIES (M2)
Negative: <0.1 Units
Borderline: 0.1-0.3 Units
Weakly positive: 0.4-0.9 Units
Positive: > or =1.0 Units
Reference values apply to all ages.

ANTINUCLEAR ANTIBODIES (ANA2)
Negative: < or =1.0 Units
Weakly positive: 1.1-2.9 Units
Positive: 3.0-5.9 Units
Strongly positive: > or =6.0 Units
Reference values apply to all ages.
Interpretive Data:
The presence of smooth muscle antibodies (SMAs) and/or antinuclear antibodies (ANAs) is consistent with a diagnosis of chronic autoimmune hepatitis, in patients with clinical and/or laboratory evidence of hepatocellular damage.

The presence of anti-mitochondrial antibodies (AMAs) is consistent with a diagnosis of primary biliary cirrhosis, in patients with clinical and/or laboratory evidence of hepatobiliary damage.
Comments:
Useful for:
Evaluation of patients with suspected autoimmune liver disease, specifically autoimmune hepatitis or primary biliary cirrhosis.

Evaluation of patients with liver disease of unknown etiology.
Methodology:
AMA: Enzyme Immunoassay (EIA)
SMA: Indirect Immunofluorescence
ANA2: Enzyme-Linked Immunosorbent Assay (ELISA)
Sample Processing:
Allow to clot completely at room temperature. Separate serum from cells ASAP.
Centrifuge within two hours of draw time.
Label transport tube with patient last name, first name, identification number, date and time of collection.
Transfer serum into new screw-capped plastic vial.
Sample Storage:
Store frozen.
Transport Instructions:
Place labeled specimen into zip-lock type biohazard bag; seal bag.
Place completed requisition into outside pocket of bag.
Place dry ice on top of specimen in Styrofoam container to maintain frozen temperature.
CPT Code:
83516 x1, 86038 x1, 86255 x1
86256-Smooth Muscle Antibodies Titer (if appropriate)