Dr Leigh Martens

General Practitioner

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Release Version: Beta

Blood-tests Explained


Disclaimer:

This website is intended to assist with patient education and should not be used as a diagnostic, treatment or prescription service, forum or platform. Always consult your own healthcare practitioner for a more personalised and detailed opinion

Anti-LKM-1


At a Glance

Why Get Tested?

To help diagnose autoimmune hepatitis and distinguish it from other causes of liver injury

When to Get Tested?

When you have hepatitis that your health practitioner suspects may be due to an autoimmune-related process

Sample Required?

A blood sample drawn from a vein in your arm

Test Preparation Needed?

None

The Test Sample

What is being tested?

Liver kidney microsome type 1 (anti-LKM-1) antibodies are autoantibodies, proteins produced by the body's immune system that recognize and target its own enzyme called cytochrome P450 2D6 (CYP2D6), a protein found primarily in liver cells. The development of anti-LKM-1 antibodies is strongly associated with type 2 autoimmune hepatitis. This test detects and measures the amount (titer) of anti-LKM-1 (or antibody against CYP2D6) in the blood.

Autoimmune hepatitis is an acute or chronic inflammation of the liver that can lead to liver cirrhosis and, in some cases, to liver failure. It is hepatitis that is not due to another identifiable cause, such as a viral infection, exposure to a drug or toxin, a hereditary disorder, or alcohol abuse. Anyone can develop the disorder, but the majority of those affected are women.

There are two main types of autoimmune hepatitis. Type 1 is the most common form of autoimmune hepatitis in the United States and is associated with the presence of smooth muscle antibodies (SMA) in the blood. Type 2 is less common and tends to be more severe. It is associated with anti-LKM-1 antibodies and primarily affects young girls and is more common in Europe than in the United States.

How is the sample collected for testing?

A blood sample is obtained by inserting a needle into a vein in the arm.

Is any test preparation needed to ensure the quality of the sample?

No test preparation is needed.

The Test

How is it used?

The liver kidney microsome type 1 antibody (anti-LKM-1 or CYP2D6 antibody) test is primarily used along with a smooth muscle antibody (SMA) and an antinuclear antibodies (ANA) test to help diagnose autoimmune hepatitis and to differentiate between the two major types, type 1 and type 2.

These tests may be used to follow up abnormal liver test findings, such as persistently increased alanine aminotransferase (ALT), aspartate aminotransferase (AST), or bilirubin. Additional tests may be ordered, such as immunoglobulins, as these may be increased with autoimmune hepatitis and/or hepatitis B and/or hepatitis C, to rule out viral hepatitis.

When is it ordered?

The anti-LKM-1 test may be ordered when a health practitioner is investigating an individual's liver disease and wants to distinguish between different causes of liver injury. It may be ordered along with other testing, such as an SMA and ANA test. These tests are usually ordered when a person presents with symptoms such as fatigue, weakness, and jaundice and has abnormal findings on routine liver tests.

Symptoms associated with autoimmune hepatitis may also include:

  • Itching
  • An enlarged liver
  • Joint aches
  • Abdominal discomfort
  • Abnormal blood vessels in the skin (spider angiomas)
  • Nausea or vomiting
  • Dark urine
  • Loss of appetite
  • Pale or clay-colored stools
  • Muscle pain (myalgia)
  • In women, lack of menstrual periods (amenorrhea)
  • Skin rashes
  • Fluid buildup (edema)

Many of these symptoms are not specific for autoimmune hepatitis; they are also seen with other causes of liver injury and with other conditions.

What does the test result mean?

A high amount or titer of anti-LKM-1 indicates that it is likely that the person tested has type 2 autoimmune hepatitis, but the result is not definitive. A liver biopsy may be performed to evaluate liver tissue for damage and scarring to help confirm the diagnosis.

If the anti-LKM-1 test is negative, but SMA and/or ANA are positive, then the person likely has type 1 autoimmune hepatitis.

If both are negative, then the person's symptoms are likely due to a cause other than autoimmune hepatitis. However, the condition is not entirely ruled out. Not all people with autoimmune hepatitis will produce anti-LKM-1 or SMA antibodies; some people produce other autoantibodies that are rarely tested.

Is there anything else I should know?

Levels of anti-LKM-1 are not closely related to the severity of a person's symptoms or to their prognosis. Levels may vary over time.

Those with type 2 autoimmune hepatitis may also have other autoimmune disorders, such as diabetes or thyroiditis.

People with chronic hepatitis C may sometimes develop a different type of anti-LKM-1 antibody. This type of antibody is not detected with the usual anti-LKM-1 test methods and is not typically tested for.

The ANA test is often performed along with an SMA test. It is a marker of an autoimmune process and is associated with several autoimmune disorders, including type 1 autoimmune hepatitis.