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Difficulty: MediumGastroenterology and Hepatology

Match each of the following autoimmune gastrointestinal or hepatobiliary disorders with its most highly associated and diagnostically useful autoantibody marker.

  • Primary biliary cholangitisAnti-mitochondrial antibodies (AMA)
  • Primary sclerosing cholangitisPerinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA)
  • Autoimmune hepatitis (Type 1)Anti-smooth muscle antibodies (ASMA)
  • Celiac diseaseAnti-tissue transglutaminase (anti-tTG) antibodies

Answer

Primary biliary cholangitis matches with anti-mitochondrial antibodies. Primary sclerosing cholangitis matches with p-ANCA. Autoimmune hepatitis matches with anti-smooth muscle antibodies. Celiac disease matches with anti-tissue transglutaminase antibodies.
Each autoimmune disease of the gastrointestinal tract and liver has specific, highly associated autoantibodies that aid in diagnosis, as correctly paired above.

Step-by-Step Solution

1
Identify the diagnostic serology for Primary biliary cholangitis.
Matches with Anti-mitochondrial antibodies (AMA).
AMA is the hallmark serologic marker for PBC, found in the vast majority of patients with the disease.
2
Identify the diagnostic serology for Primary sclerosing cholangitis.
Matches with Perinuclear anti-neutrophil cytoplasmic antibodies (p-ANCA).
PSC is closely linked to inflammatory bowel disease, particularly ulcerative colitis, and shares the characteristic p-ANCA serology.
3
Identify the diagnostic serology for Autoimmune hepatitis (Type 1).
Matches with Anti-smooth muscle antibodies (ASMA).
Type 1 autoimmune hepatitis is classically diagnosed in part by the presence of ASMA and/or ANA in the serum.
4
Identify the diagnostic serology for Celiac disease.
Matches with Anti-tissue transglutaminase (anti-tTG) antibodies.
Anti-tTG IgA is the preferred initial screening test for patients suspected of having celiac disease due to its high sensitivity and specificity.

Key Concept

Autoantibodies in Gastrointestinal and Hepatobiliary Diseases
Estimated Time:1m 0s
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Topics

Gastroenterology and Hepatology

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