Of note, anti-smooth muscle, anti-LKM
, anti-LPA, anti-SP, and antimitochondrial antibodies were also negative.
Serum autoantibodies associated with autoimmune hepatitis including anti-nuclear antibodies (ANA1), anti-smooth muscle antibodies (ASMA), anti-mitochondrial antibodies (AMA), and anti-liver kidney-microsomal antibodies (anti-LKM) were also assessed.
The level of serum autoantibodies (ANA1, ASMA, AMA, and anti-LKM) was measured using an indirect immunofluorescence method (EUROIMMUN tests, Sprinter XL Analyzer, EUROIMMUN, Germany).
Conventional serologies for AIH were unremarkable with negative ANA, ASMA, anti-LKM 1 and 3 antibodies (staining by indirect immunofluorescence), and normal serum IgG level.
Type 2 AIH is defined by the presence of specific autoantibodies against liver and kidney microsomal antigens (anti-LKM type 1 or infrequently type 3) and or anti-liver cytosol type 1 antibody (ALC-1) .
Isolated elevation of serum autoantibodies such as antinuclear antibodies (ANA), anti-smooth muscle antibodies (ASMA), anti-liver-kidney microsomal antibodies (anti-LKM), and antimitochondrial antibodies (AMA) has been described in subjects with orthotopic liver transplantation (OLT) without a history of prior autoimmune liver disease [1-5].
 detected positivity of one or more autoantibodies post-OLT (cut-off [greater than or equal to] 1:40 for ANA and/or [greater than or equal to] 1:20 for ASMA, anti-LKM, and AMA) in 51 children out of a population of 68 (75.0%).
Anti-LKM AMA-M2 (Euroline Liver Profile Euroimmun) Anti-Tg and Anti-TPO (Euroassay AntiTg+TPO IgG Euroimmun) tests were performed using the dot blot method at the Serology-Immunology unit.
Also 2 patients had ASMA one patient had anti-SS-A one patient had AMA and one patient had anti-LKM positivity (all were also ANA positive).
antibodies were not found in both groups.
Even though anti-LKM
and anti-LM are the most developed autoantibodies in autoimmune DILI (Watkins and Seeff 2006), the transient appearance of c-ANCA in our patient could be attributed to the induction of immune mechanisms by QpE.