Which autoantibody pattern is MOST characteristic of type 1 autoimmune hepatitis (AIH-1) and correlates with disease activity and relapse?

• A Anti-SLA/LP (soluble liver antigen/liver-pancreas antibody) ✓
• B Anti-LKM1 (liver-kidney microsomal antibody type 1)
• C Anti-SMA (smooth muscle antibody) and/or anti-ANA at high titres
• D Anti-mitochondrial antibody (AMA) M2 subtype

Explanation

Anti-SLA/LP antibodies are the MOST specific autoantibodies in AIH-1 (specificity >99%) and are the only AIH-specific antibodies that correlate with disease activity and risk of relapse after withdrawal of immunosuppression. Anti-ANA and anti-SMA are the classical diagnostic antibodies for AIH-1 but have lower specificity. Anti-LKM1 defines AIH-2 (predominantly paediatric). AMA M2 is the hallmark of primary biliary cholangitis (PBC), not AIH.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.