investigations
Last reviewed 02/2023
Haematology:
- greatly raised ESR
- normocytic normochromic anaemia
- prolonged prothrombin time - in severe disease
- positive LE cells - in 15% of cases
Biochemistry:
- raised serum bilirubin
- raised serum IgG
- raised serum alpha-fetoproteins - in one third of cases
- raised serum transaminases - X10
- alkaline phosphatase - normal or marginally raised
- reduced albumin - in severe disease
Special tests:
- antinuclear antibodies - in 80% of cases
- smooth muscle antibodies - in 70% of cases
- mitochondrial antibodies - low / absent
- antibodies to liver and kidney microsomes - may be present, especially in children; carry a poor prognosis
- HBsAg and anti-HCV negative
Needle biopsy:
- cellular infiltrate, predominantly lymphocytes and plasma cells, in acinar zone 1 and infiltrating between the hepatocytes
- little or no fatty change