Antimitochondrial antibody

The early reports of hepatotoxicity with iproniazid led to the synthesis of non-hydrazine inhibitors, and a report from 19 French drug surveillance centers (26) has reaffirmed the frequency and severity of this adverse effect. There were 91 cases of hepatitis due to all antidepressants (11 with iproniazid) over 5 years. Cytolytic reactions occurred in 11 patients treated with iproniazid 5 died. There was a high titer of antimitochondrial antibodies (M6) in five patients. 

Primary bihary cirrhosis May be asymptomatic. Prominent rise in alkaline phosphatase, cholesterol and bilirubin. More common in women. Diagnosis through detection of antimitochondrial antibodies, with biopsy. 

The aetiology of PBC is unknown but high titres of antimitochondrial antibody in the majority suggest involvement of immune mechanisms. There is no effective treatment. Adverse effects outweigh benefits from prednisolone, but budesonide is currently under assessment as it is highly extracted by the liver and thus poorly available to the systemic circulation. Ursodeoxycholic acid 10-15 mg/kg/d improves biochemical liver function tests, but appears not to lengthen survival or prevent complications. 

Berg, P.A., Klein, R. Antimitochondrial antibodies in primary biliary cirrhosis and other disorders definition and clinical relevance. Dig. Dis. 1992 10 85-101... 

Polymeros, D., Kamberoglon, D., Tzias, V. Acute cholestatic hepatitis caused by Teucrium polium (Golden germander) with transient appearance of antimitochondrial antibody. J. Clin. Gastroenterol. 2002 34 100-101... 

Flannery, G.R., Burroughs, A.K., Butler, R, Chelliah, J., Hamilton-Miller, J., Brumfitt, W., Baum-Het, H. Antimitochondrial antibodies in primary biliary cirrhosis recognize both specific peptides and shared epitopes of the M2 family or antigens. Hepatology 1989 10 370- 374... 

Joshl, S., Canch-Dndek, K., Heathcote, E.J., Lindor, K., Joi ensen, R., Klein, R. Antimitochondrial antibody profiles are they valid prognostic indicators in primary biliary cirrhosis Amer. J. Gastroenterol. 2002 97 999-1002... 

Klein, R., Huizenga, J.R., Gips, C.H., Berg, P.A. Antimitochondrial antibody profiles in patients with primary biUary cirrhosis before orthotopic liver transplantation and titres of antimitochondrial anti-body-subtypes after transplantation. J. Hepatol. 1994 20 181 — 189... 

Stemerowicz, R., Hopf, U., Moller, B., Wittenbrink, C., Rodloff, A., Reinhardt, R., Freudenberg, M., Galanos, C. Are antimitochondrial antibodies in primary biUary drrhosis induced by R (rough) mutants of enterobacteriaceae Lancet 1988/II 1166-1170... 

Strassburg, C.P., Jaeckel, E., Manns, M.P. Antimitochondrial antibodies and other immunological tests in primary biliary cirrhosis. Eur. J. Gastroenterol. Hepatol. 1999 11 595-601... 

Gisbert, XR, Jones, E.A., Pajares, J.M., Moreno-Otero, R. Is there an optimal therapeutic regimen for antimitochondrial antibody-negative... 

Taylor, S.L., Dean, PX, Riely, C.A. Primary autoimmune cholangitis An alternative to antimitochondrial antibody-negative primary biliary cirrhosis. Amer. J. Surg. Pathol. 1994 18 91-99... 

Positive serological markers of autoimmune hepatitis before treatment in patients with concomitant chronic hepatitis C are sometimes associated with further exacerbation of an underlying autoimmune liver disease during interferon alfa treatment. Of three patients with raised antimitochondrial antibodies (over 1 160), only the two patients with M2 (with or without M4 or M8) subtypes had biochemical exacerbation of cholestasis and an unfavorable response to interferon alfa (255). Although very few patients were investigated, determination of antibodies against submitochondrial particles may help to identify patients who are likely to have no benefit and even exacerbation of liver disease with interferon alfa. 

Garrido Palma G, Sanchez Cuenca JM, Olaso V, Pina R, Urquijo JJ, Lopez Viedma B, Bustamante M, Berenguer M, Berenguer J. Response to treatment with interferon-alfa in patients with chronic hepatitis C and high titers of -M2, -M4 and -M8 antimitochondrial antibodies. Rev Esp Enferm Dig 1999 91(3) 168-81. 

Antinuclear and antimitochondrial antibodies develop not uncommonly during long-term administration of labetalol (12). 

Antimitochondrial antibody (AMA Dihydrolipoamide acyltransferase Primary bifiary cirrhosis... 

Criteria for the diagnosis of AIH have been developed by an international group and have been revised to improve their use. The criteria include (1) exclusion of other causes of liver injury (2) elevation of aminotransferases with minimal increase in ALP (3) presence of elevated immunoglobulins positive ANA, ASMA, or anti-LKMi, with negative antimitochondrial antibody (4) compatible histological features and (5) absence of intrahepatic bile duct injury. A scoring system based on these criteria has also... 

Possible biliary cirrhosis measurement of antimitochondrial antibodies... 

Primary biliary cirrhosis (PBC). Autoimmime liver disease that results in the destruction of bile ducts, leading to fibrosis and cirrhosis. Primary biliary cirrhosis-specific are antimitochondrial antibodies directed against proteins of the pyruvate dehydrogenase complex (mainly the E2 subunit). 

Long SA, Van de Water J, Gershwin ME (2002) Antimitochondrial antibodies in primary biliary cirrhosis the role of xenobiotics. Autoimmunol Rev, 1 37-42. 

Antimitochondrial antibody Antimyocardial antibodies Antineutrophil cytoplasmic antibody... 

A few years ago Maas and Schubothe (1973) and Maas et al. (1974,1975) described a syndrome clinically resembling LE in which antimitochondrial antibodies were present, but not antinuclear antibodies. Skin manifestations were, however, absent. Not long afterwards it was pointed out that in many of these cases of pseu-do-LE syndrome there was probably a link with the substance Venopyronum (intended for diseases of veins and containing l,4-diphenyl-3,5-dioxo-pyrazolidine together with certain plant extracts). The reported data show that the patients involved had been taking this product for several months or years (Maas and Schubothe 1973 Maas et al. 1974, 1975 Muller-Schoop et al. 1975 Schwarz and JosT 1975). 

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