The Immunologic Diagnosis of Chronic Active “Autoimmune” Hepatitis: Distinction From Systemic Lupus Erythematosus

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Abstract
We have evaluated the immunologic characteristics often associated with systemic lupus erythematosus in a series of patients with a variety of different liver diseases. Antibody to doublestranded DNA as measured by the Farr assay was detected frequently in patients with various forms of liver disease. No patient with liver disease, including those with a presumed immunologic etiology, was found to have antibody to double–stranded DNA using more specific assays. Other immunologic phenomena such as the presence of immunofluorescent staining at the dermalepidermal junction in the lupus band test, circulating immune complexes and the presence of antinuclear antibody were present in a number of patients with different forms of liver disease. The absence of antibody to double–stranded DNA in patients with liver disease suggests that there may be a true immunologic distinction between systemic lupus erythematosus and chronic active (“lupoid”) hepatitis.