Test Overview

Test Methodology

Indirect Fluorescent Antibody (IFA), Mouse stomach kidney substrate

Test Usage

Mitochondrial Ab: Useful in providing confirmatory evidence in the diagnosis of primary biliary cirrhosis.
Smooth Muscle Ab: Positive in 50-80% of patients with chronic active hepatitis. Titers are negative in extra hepatic biliary obstruction. Anti-smooth muscle antibodies (SMA) are also seen in acute viral hepatitis; low titers may be seen in primary biliary cirrhosis.

Reference Range*


* Reference ranges may change over time. Please refer to the original patient report when evaluating results.

Test Limitations

Mitochondrial Ab: Level of antibody does not correlate with severity or duration of disease. Low, transient titers are sometimes seen with chlorpromazine or halothane sensitivity.
Smooth Muscle Ab: Presence of strong antinuclear antibody may interfere with the interpretation of smooth muscle antibody.

Test Details

Days Test Performed

Tuesday, Friday

Analytic Time

8 hours

Soft Order Code


MiChart Code

Mitochondrial and Smooth Muscle Ab Panel


Chemical Pathology

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Specimen Requirements

Offsite Collection Instructions

Collect specimen in SST tube. Centrifuge, aliquot serum into a plastic vial and refrigerate.


Yellow Top Tube

Normal Volume

1.0 mL serum

Minimum Volume

0.5 mL serum

Additional Information

Mitochondrial Ab: A positive test for Mitochondrial antibody in the presence of increase alkaline phosphatase activity, elevated cholesterol, and elevated IgM concentrations, strongly supports the diagnosis of primary biliary cirrhosis (PBC). The liver mitochondrial antibody is generally absent in drug-induced cholestatic jaundice, viral hepatitis, sclerosing cholangitis, alcoholic and other forms of cirrhosis, hepatic malignancy, and other immune diseases.
Smooth Muscle Ab: Smooth muscle antibody measurements are useful in confirming the diagnosis of chronic active hepatitis (CAH). Titers generally range from 1:80 - 1:320 and persist for years. In viral hepatitis the titers are below 1:80 and are transient. Low titers (1:20 to 1:40) are found in approximately 50% of patients with primary biliary cirrhosis. If another antibody including Parietal Cell Antibody, Mitochondrial Antibody, or Liver Kidney Microsomal Antibody is noted to be present during the performance of this test, the client will be notified via comment in the report. Please contact MLabs Client Services Center to request the additional auto-antibody; there will be a separate charge for each auto-antibody test ordered.

Billing Information

Fee Codes

CPT Code

86256 (MITO), 86256 (SM)


5247-2 (MITO), 5358-7 (SM)

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