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Abstract: (768 Views)
Backgrounds and Objectives: Autoimmune liver diseases (ALD) are a heterogenous group of disorders affecting the hepatobiliary system and are characterised by specific autoantibodies. These are routinely measured in the diagnostic laboratory yet the ordering characteristics and diagnostic performance of autoimmune liver disease (ALD) autoantibodies measured by commercial line immunoblot (LIB) have not been well characterised. This study aims to examine such characteristics in a major tertiary hospital laboratory.
Methods: Over 12 months, all patients who were referred to our laboratory for an ALD-LIB were included in the cross-sectional audit. Medical notes were reviewed to ascertain the reasons and diagnoses for patients. Patients who had at least one positive ALD autoantibody on LIB were defined as “blot positive” and compared to blot negative patients. Performance for diagnosing ALD was assessed by calculating sensitivities and specificities with respect to non-ALD patients.
Results: There were 611 patients in the 12-month period. Sixty-four of these patients (10%) were blot positive. These patients tended to be female, have other ALD-associated autoantibodies and lower alkaline phosphatase (ALP) levels compared to blot negative patients. An ALD diagnosis or systemic autoimmune disease were more likely to be encountered in blot-positive patients. Finally, the LIB provided high negative predictive value for an ALD in this cohort of patients.
Conclusion: This real-world analysis of the ALD-LIB revealed insights into the reasons, performance and patient characteristics that are referred for this test. When combined with other ALD, the ALD-LIB is an useful adjunct in the evaluation of patients for possible ALD.
Methods: Over 12 months, all patients who were referred to our laboratory for an ALD-LIB were included in the cross-sectional audit. Medical notes were reviewed to ascertain the reasons and diagnoses for patients. Patients who had at least one positive ALD autoantibody on LIB were defined as “blot positive” and compared to blot negative patients. Performance for diagnosing ALD was assessed by calculating sensitivities and specificities with respect to non-ALD patients.
Results: There were 611 patients in the 12-month period. Sixty-four of these patients (10%) were blot positive. These patients tended to be female, have other ALD-associated autoantibodies and lower alkaline phosphatase (ALP) levels compared to blot negative patients. An ALD diagnosis or systemic autoimmune disease were more likely to be encountered in blot-positive patients. Finally, the LIB provided high negative predictive value for an ALD in this cohort of patients.
Conclusion: This real-world analysis of the ALD-LIB revealed insights into the reasons, performance and patient characteristics that are referred for this test. When combined with other ALD, the ALD-LIB is an useful adjunct in the evaluation of patients for possible ALD.
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