The immunologic diagnosis of chronic active “autoimmune” hepatitis: Distinction from systemic lupus erythematosus

Authors

  • Lawrence E. Gurian,

    1. Departments of Internal Medicine and Dermatology, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas 75235 and the Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas 77030
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  • Thomas M. Rogoff,

    1. Departments of Internal Medicine and Dermatology, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas 75235 and the Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas 77030
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  • Athol J. Ware M. D.,

    Corresponding author
    1. Departments of Internal Medicine and Dermatology, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas 75235 and the Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas 77030
    • Liver Unit, Department of Internal Medicine, University of Texas Health Science Center at Dallas, 5323 Harry Hines Boulevard, Dallas, Texas 75235
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  • Robert E. Jordan,

    1. Departments of Internal Medicine and Dermatology, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas 75235 and the Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas 77030
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  • Burton Combes,

    1. Departments of Internal Medicine and Dermatology, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas 75235 and the Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas 77030
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  • James N. Gilliam

    1. Departments of Internal Medicine and Dermatology, The University of Texas Health Science Center at Dallas, Southwestern Medical School, Dallas, Texas 75235 and the Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas 77030
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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.

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