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Disease Topics — Autoimmune hepatitis (AIH) is a chronic autoimmune liver disease (ALD) that is characterized by hypergammaglobulinemia. If diagnosed and treated promptly, patients can expect a normal or nearly normal life expectancy. However, if untreated, AIH leads to cirrhosis and liver failure, with…
Indications for TestingTesting for AIH should be considered in all individuals who present with acute or chronic liver disease (including acute liver failure) or abnormal liver function tests (elevated aspartate aminotransferase [AST] and alanine aminotransferase [ALT]), particularly when…
Disease Topics — Hepatitis, or inflammation of the liver, may be caused by autoimmune processes, drug toxicity, as well as bacterial and viral infections.
Indications for TestingLaboratory testing for viral hepatitis is used to , , , :
Algorithm — A patient may have symptoms of liver disease or hepatitis without a clear cause. If the patient has elevated transaminases but all viral serologies are negative, more testing is needed. An initial workup for liver disease of unknown etiology includes testing for autoimmune liver disease and…
Disease Topics — Autoimmune neuropathies arise when a dysregulated immune system targets “self-antigens,” leading to peripheral nervous system damage.
Indications for Autoantibody TestingAntibody testing should be considered in individuals presenting with severe or rapidly progressive muscle weakness and/or sensory symptoms and with no known underlying etiology.
Disease Topics — There is a broad spectrum of laboratory tests used to evaluate liver function and liver damage. Colloquially, these are referred to as liver function tests, although they are not all direct measures of liver function. Liver testing generally includes alanine transaminase (ALT), aspartate…
Indications for TestingTesting may be ordered as part of a routine evaluation or to screen for and monitor liver disease (e.g., viral or alcoholic hepatitis). Test selection should be informed by patient history and clinical evaluation.
Disease Topics — Connective tissue or systemic autoimmune rheumatic diseases (SARDs) are characterized by autoantibodies that can affect tissues and organs throughout the body.
Indications for TestingThe following SARDs may manifest with these indications:
Disease Topics — Primary biliary cholangitis (PBC), previously referred to as primary biliary cirrhosis, is an autoimmune liver disorder characterized by chronic, progressive cholestatic disease.
Indications for TestingLaboratory testing for PBC is used to
Disease Topics — Primary sclerosing cholangitis (PSC) is a progressive autoimmune liver disease (ALD) that often leads to cirrhosis and may eventually require liver transplantation. There is a strong association between PSC and inflammatory bowel disease (IBD), and the two conditions often occur together…
Indications for TestingPSC should be considered in patients with elevated alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT), symptoms of liver disease (e.g., jaundice, pruritus, cholangitis), variceal bleeding, or cholangiocarcinoma (CCA).
Disease Topics — Sjögren syndrome is an autoimmune disease characterized by lymphocytic infiltration of exocrine glands that results in dry eyes and dry mouth; other common symptoms include fatigue and joint pain. The disease may affect as many as four million people in the United States and is one of the…
Criteria for DiagnosisThe American College of Rheumatology (ACR) and European League Against Rheumatism (EULAR) classification criteria for primary Sjögren syndrome are listed in the table below.
Disease Topics — Hemolytic anemias, which result from premature destruction of red blood cells (RBCs), may be hereditary or acquired.
Indications for TestingPatients with unexplained anemia, particularly with reticulocytosis and/or evidence of hemolysis, should be evaluated for hemolytic anemias. Suggestive symptoms that may prompt investigation include acute jaundice and hematuria, as well as nonspecific symptoms of anemia such…