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Subject: Anti–Smooth Muscle Antibodies (ASM)
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Smooth muscle antibodies are directed toward actin, myosin, and occasionally against other contractile proteins in muscle cells. Smooth muscle antibodies can present in a variety of liver disease states. Smooth muscle antibodies can be useful in differentiating liver disease when used in conjunction with other laboratory results and the patient's clinical symptoms.
IFA: negative; if positive, results are tittered, ELISA: <1:40 titer.
ASM titers >1:40 are significant.
Aids in the diagnosis of chronic active hepatitis
Differential diagnosis of liver disease
Rule out SLE (test usually negative in SLE)
Chronic active hepatitis
Autoimmune hepatitis type 1
Primary biliary cirrhosis
Primary sclerosing cholangitis
A positive test is not diagnostic for any one disease state.
Low titers are seen in acute viral hepatitis, PBC, infection mononucleosis, malignant myeloma, and ovarian carcinoma.