Antinuclear antibodies and patterns of nuclear immunofluorescence in type 1 autoimmune hepatitis.
To determine the significance of antinuclear antibodies and their patterns of indirect immunofluorescence in type 1 autoimmune hepatitis, sera from 99 patients were evaluated. Patients with antinuclear antibodies had a lower frequency of liver transplantation (6% vs 22%, P = 0.04) than seronegative patients. They were also more commonly HLA-DR4-positive than seronegative patients (56% vs 30%, P = 0.05) and normal subjects (56% vs 30%, P = 0.004). The 42 patients with antinuclear antibodies and a diffuse pattern of indirect immunofluorescence had higher serum titers of ANA (serum titers > or = 1:500, 71% vs 14%, P < 0.0001) and SMA (serum titers > or = 1:500, 69% vs 27%, P = 0.003) than the 22 patients with antinuclear antibodies and a speckled pattern. These patients, however, were otherwise not distinguished by clinical features and treatment response. Patients with a speckled pattern had A1-B8-DR3 more frequently than patients with a diffuse pattern (65% vs 23%, P = 0.005) and normal subjects (65% vs 13%, P < 0.0001), but they had no other salient features. We conclude that patients with antinuclear antibodies have a better long-term prognosis than seronegative patients, and they have HLA-DR4 more commonly. The patterns of indirect immunofluorescence associated with ANA positivity have no practical clinical implications.
Czaja
A J
AJ
Division of Gastroenterology and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Cassani
F
F
Cataleta
M
M
Valentini
P
P
Bianchi
F B
FB
D000328:Adult; D000974:Antibodies, Antinuclear / Q000097:blood*; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000276:immunology*; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006684:HLA-DR Antigens / Q000032:analysis; D006505:Hepatitis / Q000276:immunology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009130:Muscle, Smooth / Q000276:immunology; D011379:Prognosis
D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D006684:HLA-DR Antigens