[Chronic active hepatitis associated with anti-native DNA antibodies: incidence of drug etiology]

Gastroenterol Clin Biol. 1984 Nov;8(11):833-7.
[Article in French]

Abstract

Of 75 patients with HBsAg negative chronic active hepatitis (CAH), 28 had antinuclear antibodies in their serum. We have tested these patients' sera for serum antibodies against double stranded (native) DNA (anti-ds-DNA), by immunofluorescence with Crithidia luciliae as substrate. They were found in 14 patients (50 p. 100). Thirteen of the patients with anti-ds-DNA and 11 of those without were female; the mean ages were 64 +/- 16 and 56 +/- 19 years, respectively. The clinical and biological signs seemed to be more severe in patients with anti-ds-DNA than in those without. Liver histological activity and frequency of cirrhosis (about 50 p. 100) were similar in patients with or without anti-ds-DNA. Ten of the 14 patients with anti-ds-DNA had been given hepatotoxic drugs whereas only 2 patients lacking these antibodies had taken a hepatotoxic drug (p less than 0.01). In subjects with anti-ds-DNA, clometacin was the most common hepatotoxic drug, taken alone in 5 patients or together with other hepatotoxic drugs in 3 subjects. Only 4 of the patients with anti-ds-DNA displayed symptoms of systemic lupus erythematosus and two of these subjects took a hepatotoxic drug. In our experience, serum anti-ds-DNA were frequently found in patients with CAH and antinuclear antibodies; in this group CAH was often associated with hepatotoxic drugs, especially clometacin. Thus, the presence of anti-ds-DNA in sera of patients with HBsAg negative CAH may be an indication of drug-induced liver damage.

MeSH terms

  • Antibodies, Antinuclear / analysis*
  • Chemical and Drug Induced Liver Injury / immunology*
  • Chemical and Drug Induced Liver Injury, Chronic
  • DNA / immunology*
  • Female
  • Fluorescent Antibody Technique
  • Hepatitis, Chronic / immunology*
  • Humans
  • Indoleacetic Acids / adverse effects
  • Male
  • Time Factors

Substances

  • Antibodies, Antinuclear
  • Indoleacetic Acids
  • DNA
  • clometacin