Primary and secondary liver/kidney microsomal autoantibody response following infection with hepatitis C virus

Gastroenterology. 1994 Jun;106(6):1672-5. doi: 10.1016/0016-5085(94)90426-x.


Liver/kidney microsomal autoantibody type 1 (LKM-1), which characterizes a subtype of autoimmune hepatitis, is also found in some patients with chronic hepatitis C virus (HCV) infection. Whether HCV and LKM-1 are accidentally or causally related is unknown. This case report describes a child who became infected by HCV after liver transplantation for end-stage liver disease caused by alpha 1-antitrypsin deficiency. LKM-1 was detected by immunofluorescence, anti-microsomal reactivity by Western blotting, anti-HCV and anti-GOR by immunoenzymatic assays, and HCV RNA by polymerase chain reaction. Two weeks after HCV infection, immunoglobulin (Ig) M LKM-1 appeared, followed by IgG1 LKM-1, with titers increasing to 1/2560; antibodies to a 50-kilodalton liver microsomal protein appeared 2 months later. Sera from day 1 posttransplant became positive for HCV RNA. HCV RNA was also detected in a liver biopsy specimen obtained 3 months after surgery. The patient did not produce anti-HCV and anti-GOR antibodies throughout the study and had no histological evidence of hepatitis. The temporal relationship between HCV infection and LKM-1 production suggests that HCV may trigger a primary autoimmune response. The lack of liver damage attributable to autoimmunity or viral infection may be caused by immunosuppression.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antibody Formation
  • Autoantibodies / immunology*
  • Child
  • Female
  • Hepacivirus / genetics
  • Hepatitis C / etiology
  • Hepatitis C / immunology*
  • Hepatitis C / microbiology
  • Humans
  • Liver Transplantation
  • Postoperative Complications
  • RNA, Viral / analysis


  • Autoantibodies
  • RNA, Viral
  • anti-liver kidney microsome antibody