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[Liver diseases with microsomal antibodies. Frequency, clinical and immunological findings and course observations
Abstract:
Microsomal antibodies (LKM-antibodies) differ in the indirect immunfluorescence by use of rat organ sections (kidney, stomach, and liver) from mitochondrial antibodies by there reaction with proximal renal tubules and hepatocytes while parietal cells usually fail to stain. In contrast to other humoral autoantibodies LKM-antibodies are rare. In a prospective study on 930 adults and 33 children with two third chronic hepatitis resp. cirrhosis frequency in the first group amounts to 0.38% and in the latter to 6.9% of all liver diseases. Among six patients with LKW-antibodies and chronic active hepatitis there were three children aged 4-13 and three adults between 45-55 years. On common results two children showed beside LKM-antibodies by absence of other immunphenomenons a rise of gamma-globulins in the electrophoresis and immunglobulin G as well as a chronic active hepatitis with necrosis leading in spite of initial rapid progression and persistent antibodies into inactive postnecrotiv cirrhosis. The other four patients showed no common course in respect to clinical, histological and immunological findings.
Insights
Liver kidney microsomal antibodies (LKM-antibodies) are rare humoral autoantibodies. A study found LKM-antibodies in 6.9% of pediatric liver disease cases, suggesting a role in chronic hepatitis.
Area of Science:
- Autoimmunology
- Hepatology
- Nephrology
Background:
- Microsomal antibodies (LKM-antibodies) are rare humoral autoantibodies distinct from mitochondrial antibodies.
- LKM-antibodies target hepatocytes and renal tubules, unlike antibodies that stain parietal cells.
Observation:
- A prospective study analyzed 930 adults and 33 children with chronic hepatitis or cirrhosis.
- LKM-antibodies were detected in 0.38% of adults and 6.9% of children with liver diseases.
Findings:
- Six patients (3 children, 3 adults) with LKM-antibodies and chronic active hepatitis were identified.
- Two children with LKM-antibodies developed inactive postnecrotic cirrhosis despite initial rapid progression.
Implications:
- LKM-antibodies are more prevalent in pediatric liver disease than in adults.
- The clinical course associated with LKM-antibodies can vary, even leading to cirrhosis in some cases.