IMMUNOLOGY - Roit A. - Mir 2000

Chapter 28. Autoimmune Processes and Autoimmune Diseases

DIAGNOSTIC AND PROGNOSTIC SIGNIFICANCE OF AUTOANTIBODIES

Regardless of the role autoantibodies play in the pathological process, they frequently serve as its markers and hold significant diagnostic value. For instance, the detection of antimitochondrial Antibodies is used in the Diagnosis of Primary biliary cholangitis (Fig. 28.25). Previously, establishing a diagnosis of this disease required an exploratory laparotomy, which, given the age and condition of the patients, was far from safe.

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Fig. 28.25. For the Cytology/practical/136.html">Differential diagnosis OF these diseases, along with percutaneous Liver biopsy, one can use the method for detecting mitochondrial antibodies based on indirect immunofluorescence. Antimitochondrial antibodies are present in the majority of patients with primary biliary cirrhosis, but in less than half of patients with cryptogenic cirrhosis or chronic active hepatitis; these antibodies are rare in other conditions.

As shown in Fig. 28.26, autoantibodies—specifically against pancreatic islet β-Cells—can also have prognostic value.

Fig. 28.26. Prospective study of a family with Insulin-dependent Diabetes Mellitus (the age of each family member at THE START OF the study is indicated). In a sibling who shared an HLA haplotype with the proband and had Complement-fixing islet Cell antibodies, diabetes developed 2 years later.