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Anti‐neutrophil cytoplasmic antibodies in type 1 and 2 autoimmune hepatitis
Author(s) -
Zauli D,
Ghetti S,
Grassi A,
Descovich C,
Cassani F,
Ballardini G,
Muratori L,
Bianchi F B
Publication year - 1997
Publication title -
hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.488
H-Index - 361
eISSN - 1527-3350
pISSN - 0270-9139
DOI - 10.1002/hep.510250510
Subject(s) - panca , autoimmune hepatitis , medicine , autoantibody , antibody , immunology , autoimmunity , hepatitis c virus , sma* , hepatitis , anti neutrophil cytoplasmic antibody , virus , disease , vasculitis , mathematics , combinatorics
Perinuclear anti‐neutrophil cytoplasmic antibodies (pANCA) have been recently defined as the most sensitive autoantibody of type 1 autoimmune hepatitis (AIH‐1). Their prevalence in type 2 autoimmune hepatitis (AIH‐2) has not yet been evaluated. The aim of the present study was to verify the association of pANCA with AIH‐1 in an Italian series and to investigate the prevalence of the antibodies in AIH‐2 and in proper control groups represented by cases of chronic hepatitis C (CH‐C) with similar autoimmune features. pANCA were found in 30 of 46 (65%) AIH‐1 and in 4 of 30 (13%) ANA/smooth muscle antibody (SMA) positive CH‐C ( P = .6). Nineteen AIH‐2, 29 liver kidney microsomal antibody type 1/liver cytosol antibody type 1 (LKM1/LC1) positive CH‐C cases and 50 healthy controls were all negative. In AIH‐ 1, pANCA were significantly ( P = .009) more frequent in males (8 of 9, 89%) than in females (22 of 37, 59%). All pANCA positive sera showed SMA of the antiactin type. The present data confirm that pANCA, although less prevalent in our series than in other reports, do associate with AIH‐1 also in the Mediterranean area and show that it can identify a small subgroup (13%) of ANA/SMA positive chronic hepatitis C, in which autoimmune reactions might play a more relevant role than viral infection. They also show the antibodies are absent in AIH‐2. In conclusion, pANCA appear to be mutually exclusive of LKM1 positivity, either hepatitis C virus‐related or not, thus representing a further valuable tool to differentiate the two types of autoimmune hepatitis.