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Laboratory: Clinical Immunology
Test Name:
Test Code: LDP
Clinical Information:
LDP testing includes both HEP2 and LKS (AMA/SMA/LKM)
Testing is performed at St. Boniface Hospital Immunology Lab using an indirect Immunofluorescence assay (IFA).  Serum samples are initially screened at a 1:80 dilution for HEP2 and 1:100 dilution for LKS.
This test is designed for the semiquantitative in vitro determination of human antibodies of immunoglobulin class IgG against cell nuclei (ANA) in patient samples for the diagnosis of many autoimmune diseases, particularly those of the rheumatic form.  ANA is also found in 30-40% of autoimmune hepatitis patients.
The determination of AMA is of particular significance in the diagnosis of
primary biliary liver cirrhosis
Antibodies against smooth muscle (SMA) occur in various liver diseases (chronic hepatitis, liver cirrhosis). Their determination is of particular significance in the diagnosis of autoimmune (lupoid) hepatitis (AIH).
Liver-Kidney Microsome antibody (anti-LKM) is useful for the evaluation of patients with liver disease of unknown etiology.   It may be observed in patients with autoimmune hepatitis type 2 (AIH-2), AIH-2 associated with autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED), viral hepatitis C or D, and some forms of drug-induced hepatitis
Collection Devices:
Specimen Required:
Blood: 5.0 mL

Serum: 1.0 mL
Serum: 1.0 mL

Separate serum and ship refrigerated, or frozen if greater than 7 days from time of collection.
Reference Values:
HEP2:  <1:80 Titre (Negative)
Liver Disease Profile:
Mitochondrial Ab:                    <1:100 Titre (Negative)
Smooth Muscle Ab:                  <1:100 Titre (Negative)
Liver Kidney Microsomal Ab:  <1:100 Titre (Negative)
A negative result does not necessarily exclude autoimmune disease.  Positive results should not be interpreted in isolation and must be correlated with relevant clinical findings.
Laboratory Hours of Operation: Mon-Fri, 0800-1615, excluding holidays. LDP TAT: within 4 days
See Also:
More Information:
Positive results will also be accompanied by a Pattern (HEP2) and Titre.
No reflex testing will be performed for positive results.