[Chronic active hepatitis associated with anti-native DNA antibodies: incidence of drug etiology].
Of 75 patients with HBsAg negative chronic active hepatitis (CAH), 28 had antinuclear antibodies in their serum. We have tested these patients' sera for serum antibodies against double stranded (native) DNA (anti-ds-DNA), by immunofluorescence with Crithidia luciliae as substrate. They were found in 14 patients (50 p. 100). Thirteen of the patients with anti-ds-DNA and 11 of those without were female; the mean ages were 64 +/- 16 and 56 +/- 19 years, respectively. The clinical and biological signs seemed to be more severe in patients with anti-ds-DNA than in those without. Liver histological activity and frequency of cirrhosis (about 50 p. 100) were similar in patients with or without anti-ds-DNA. Ten of the 14 patients with anti-ds-DNA had been given hepatotoxic drugs whereas only 2 patients lacking these antibodies had taken a hepatotoxic drug (p less than 0.01). In subjects with anti-ds-DNA, clometacin was the most common hepatotoxic drug, taken alone in 5 patients or together with other hepatotoxic drugs in 3 subjects. Only 4 of the patients with anti-ds-DNA displayed symptoms of systemic lupus erythematosus and two of these subjects took a hepatotoxic drug. In our experience, serum anti-ds-DNA were frequently found in patients with CAH and antinuclear antibodies; in this group CAH was often associated with hepatotoxic drugs, especially clometacin. Thus, the presence of anti-ds-DNA in sera of patients with HBsAg negative CAH may be an indication of drug-induced liver damage.
D000974:Antibodies, Antinuclear / Q000032:analysis*; D056486:Chemical and Drug Induced Liver Injury / Q000276:immunology*; D056487:Chemical and Drug Induced Liver Injury, Chronic; D004247:DNA / Q000276:immunology*; D005260:Female; D005455:Fluorescent Antibody Technique; D006521:Hepatitis, Chronic / Q000276:immunology*; D006801:Humans; D007210:Indoleacetic Acids / Q000009:adverse effects; D008297:Male; D013997:Time Factors
D000974:Antibodies, Antinuclear; D007210:Indoleacetic Acids; D004247:DNA; C017136:clometacin
Hépatites chroniques actives associées à des anticorps anti-ADN natif: fréquence de l'étiologie médicamenteuse.