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Autoimmune

Smooth muscle antibodies (SMA): autoimmune hepatitis in women and the result

Smooth muscle antibodies (SMA) are autoantibodies: antibodies that the immune system makes by mistake against healthy cells of the body in an autoimmune disease, while antibodies normally attack germs such as viruses and bacteria. They target proteins from the muscle layer of hollow organs such as the intestines and the blood vessels, proteins that according to MedlinePlus are also common in liver cells.

According to the NVKC, smooth muscle antibodies are strongly linked to chronic autoimmune hepatitis, a long-lasting liver inflammation caused by the body's own immune system that according to MedlinePlus can lead to cirrhosis and liver failure without treatment. Only a blood test shows whether these antibodies are in the blood.

Certe and Diagnostiek voor U give 'negative' as the expected result, and Diagnostiek voor U counts a titre below 20 as negative.

Doctor's Assessment Included

SMA are antibodies that the body's own immune system makes against smooth muscle, the muscle tissue in the gut and other organs. Normally the result is negative; Diagnostiek voor U counts a titre below 20 as negative.

  • According to the NVKC, a positive result for smooth muscle antibodies is not yet proof of autoimmune hepatitis, a liver inflammation caused by the body's own immune system; together with a confirmed liver inflammation it is a strong sign.
  • In adults, the 2015 European liver guideline (EASL) counts a smooth muscle antibody titre of 1:40 or higher, measured by immunofluorescence, as significant.
  • A negative smooth muscle antibody result does not rule out autoimmune hepatitis: according to EASL, in some patients the antibodies may only turn positive months later in the course of the disease.

Smooth Muscle Antibodies (SMA): what this test measures

According to the NVKC, the smooth muscle antibody test shows whether these antibodies are in the blood, and to what extent. Diagnostiek voor U expresses the result as a titre, and according to the European liver guideline of EASL a titre is a dilution of the serum, such as 1:40.

Smooth Muscle Antibodies (SMA): why this value matters

According to MedlinePlus, smooth muscle antibodies belong to type 1 autoimmune hepatitis, the most common type, and according to MedlinePlus that type is more common in women. According to the NVKC, about 80% of patients with autoimmune hepatitis have smooth muscle antibodies in their blood.

Smooth Muscle Antibodies (SMA): how the blood test works

Referral
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The draw
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Where
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Smooth Muscle Antibodies (SMA): when is testing worthwhile?

According to the NVKC, a smooth muscle antibody test is requested to find the cause of a liver inflammation, usually together with other autoantibody tests such as ANA, antibodies against the cell nucleus. According to EASL, autoimmune hepatitis can start at any age, and in women also during a pregnancy or, more often, after giving birth.

Smooth Muscle Antibodies (SMA): symptoms of a high or low value

Low Levels

A negative smooth muscle antibody result is the expected result at Certe and Diagnostiek voor U. According to EASL, a negative result does not rule out autoimmune hepatitis: in some patients with an acute onset of the disease, these antibodies may still be negative at the first test.

High Levels

According to the NVKC, a positive smooth muscle antibody result only becomes a strong sign of autoimmune hepatitis when a liver inflammation has also been found by other tests. According to EASL, missed periods (amenorrhoea) are common in autoimmune hepatitis, alongside symptoms that are not specific, such as tiredness, nausea, poor appetite, itching, fluctuating jaundice and pain in the upper right abdomen. According to MedlinePlus, autoimmune hepatitis sometimes causes no symptoms yet at the start.

Smooth Muscle Antibodies (SMA): causes of a low or high value

What raises the value

  • Autoimmune hepatitis

    Antibodies against smooth muscle are found in about 80 percent of people with autoimmune hepatitis, a liver inflammation caused by the body's own immune system.

  • Other liver diseases

    Antibodies against smooth muscle can also occur in other forms of liver disease.

  • Other autoimmune diseases

    Antibodies against smooth muscle are also found in other autoimmune diseases, which is why they are not specific to autoimmune hepatitis.

  • Healthy people, usually temporarily

    Antibodies against smooth muscle can be present in fewer than 3 percent of healthy people, usually temporarily.

Smooth Muscle Antibodies (SMA): lifestyle and this value

A positive SMA result is a result to take to your GP. According to MedlinePlus, autoimmune hepatitis is often treated with medicines that calm the immune system, and an early diagnosis with treatment can make cirrhosis less likely.

Smooth Muscle Antibodies (SMA): frequently asked questions

Is autoimmune hepatitis more common in women?

Yes, autoimmune hepatitis, the liver inflammation that a smooth muscle antibody test looks for according to the NVKC, is about three times as common in women as in men (3:1) according to the European liver guideline of EASL. According to the NVKC, by far most patients are women.

What does autoimmune hepatitis do during a pregnancy?

Autoimmune hepatitis, a liver disease in which according to the NVKC smooth muscle antibodies are found in about 80% of patients, usually calms down during a pregnancy according to EASL, but a flare after giving birth is common. According to EASL, complications for mother and child in autoimmune hepatitis are similar to those in the general population.

Can smooth muscle antibodies occur without disease?

Yes, according to the NVKC, smooth muscle antibodies can be present in fewer than 3% of healthy people, and then usually temporarily.

Smooth Muscle Antibodies (SMA): sources

  1. NVKC, Alles over testen: Anti-gladde spier, allesovertesten.nl, geraadpleegd 2026-10-06 (retrieved 2026) allesovertesten.nl

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Smooth Muscle Antibodies (SMA)

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