Anti-liver kidney microsomal antibody assay (LKM)
In 1973, Rizzetto first discovered anti-liver/kidney microsomal antibodies (anti-LKM) in some patients with chronic hepatitis using indirect immunofluorescence, which react with hepatic cytoplasm and proximal tubules. The anti-mitochondrial antibodies of primary biliary cirrhosis can cause distal tubular infection. Subsequently, three subtypes of LKM antibodies were identified. LKM-1 is a serological marker of type II autoimmune hepatitis. LKM-2 is only found in drug-induced hepatitis caused by trinic acid. Therefore, LKM-1 must be The LKM-2 is distinguished. LKM-3 is mainly found in some patients with chronic hepatitis D. LKM is mainly identified by indirect immunofluorescence. The principle of indirect immunofluorescence experiments is to label fluorescein on the corresponding antibody and directly react with the corresponding antigen. In the first step, an unknown unlabeled antibody (sample to be tested) is added to a known antigen sample, and incubated at 37 ° C for 30 min in a wet box to sufficiently bind the antigen antibody, followed by washing to remove unbound antibody. In the second step, a fluorescently labeled anti-globulin antibody or an anti-IgG, IgM antibody is added. If an antigen-antibody reaction occurs in the first step, the labeled anti-globulin antibody will further bind to the antigen-bound antibody, thereby identifying an unknown antibody.Basic Information
Specialist classification: Digestive examination classification: immune examination
Applicable gender: whether men and women apply fasting: not fastingAnalysis results:
Prompt that there may be hepatitis.
Indirect immunofluorescence was negative.Clinical significance
The anti-LKM-1 antibody is a AIH-II type serum-specific antibody with a sensitivity of 90% and a low detection rate in AIH (about 10%). Anti-LKM-1 antibodies can also be detected in approximately 2% to 10% of patients with chronic hepatitis C. AIH anti-LKM-1 antibody-positive patients, more typical autoimmune phenomenon, mostly young women, high antibody titer, serum immunoglobulin significantly increased, the condition is more serious, good response to hormone therapy, Europe and the United States More common; HCV infection with anti-LKM-1 antibody positive patients, mostly older, women are rare, low antibody titer, serum immunoglobulin is not high, the condition is chronic hepatitis, treatment of interferon Responsive, more common in the Mediterranean.
The anti-LKM-2 antibody was only found in patients with hepatitis induced after the application of the drug tinic acid. Since the drug has been discontinued, anti-LKM-2 antibodies are no longer present.
Anti-LKM-3 antibodies are found in 10% to 15% of patients with chronic hepatitis D. About 10% of patients with AIH-II have both anti-LKM-1 and anti-LKM-3 antibodies. Anti-LKM-3 antibodies have higher titers in AIH-II patients and lower titers in patients with hepatitis D.Precautions
First, the precautions before blood draw:
1, do not eat too greasy, high-protein food the day before the blood, to avoid heavy drinking. The alcohol content in the blood directly affects the test results.
2. After 8 pm on the day before the medical examination, you should start fasting for 12 hours to avoid affecting the test results.
3, should relax when taking blood, to avoid the contraction of blood vessels caused by fear, increase the difficulty of blood collection.
Second, after blood draw should pay attention to:
1. After blood is drawn, local compression is required at the pinhole for 3-5 minutes to stop bleeding. Note: Do not rub, so as not to cause subcutaneous hematoma.
2, the pressing time should be sufficient. There is a difference in clotting time for each person, and some people need a little longer to clotting. Therefore, when the surface of the skin appears to be bleeding, the compression is stopped immediately, and the blood may be infiltrated into the skin due to incomplete hemostasis. Therefore, the compression time is longer to completely stop bleeding. If there is a tendency to bleed, the compression time should be extended.
3, after the blood draw symptoms of fainting such as: dizziness, vertigo, fatigue, etc. should immediately lie down, drink a small amount of syrup, and then undergo a physical examination after the symptoms are relieved.
4. If there is localized congestion, use a warm towel after 24 hours to promote absorption.
3. Please inform the doctor about the recent medication and special physiological changes before the test.Inspection process
Same as ELISA.Not suitable for the crowd
There are no taboos.Adverse reactions and risks
There are no related complications and hazards.