Evaluation of the Crithidia assay to distinguish between auto-immune chronic active hepatitis and systemic lupus erythematosus |
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Authors: | BARBARA A LEGGETT RUSSELL J COLLINS W GRAHAM E COOKSLEY ROGER L PRENTICE LAWRIE W POWELL |
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Affiliation: | Departments of Medicine and Biochemistry, University of Queensland and Division of Immunology, Department of Pathology, Royal Brisbane Hospital, Brisbane, Australia |
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Abstract: | The aim of this study was to determine if the Crithidia luciliae assay for auto-antibodies to double-stranded DNA, often positive in systemic lupus erythematosus, is always negative in auto-immune chronic active hepatitis (CAH) as has recently been suggested. Twenty-five patients were identified as having auto-immune CAH. Mean duration of follow-up was 10.5 years. Antinuclear antibodies were detected in 92%, smooth muscle antibodies in 76% and antimitochondrial antibodies in 16%. Antibodies to double-stranded DNA were detected by the Crithidia assay in four patients (16%). Two of these patients had positive tests on only one occasion and no features of systemic lupus erythematosus. In the other two the assay was persistently positive. During follow-up both developed arthritis and serositis but the liver lesion remained the dominant clinical feature. It was concluded that there is significant serological overlap between auto-immune CAH and systemic lupus erythematosus making the Crithidia assay unreliable in distinguishing between them. |
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Keywords: | auto-immune chronic active hepatitis Crithidia luciliae systemic lupus erythematosus auto-antibodies |
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