Arthritis & Rheumatism, Volume 62,
November 2010 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Atlanta, Georgia November 6-11, 2010.
Anti-Double Stranded DNA and Other Autoantibodies Are Common in Alaska Native Autoimmune Hepatitis Patients.
Ferucci1, Elizabeth D., Hurlburt1, Kathy J., Livingston1, Stephen, Plotnik1, Julia, Gove1, James, McMahon1, Brian J., James2, Judith A.
Autoimmune hepatitis has been associated with rheumatoid arthritis and other autoimmune diseases. The purpose of this study was to determine the prevalence of autoantibodies related to rheumatoid arthritis (RA) and connective tissue diseases in autoimmune hepatitis (AIH).
Alaska Native study participants were recruited at hepatitis clinics provided by the Alaska Native Tribal Health Consortium Liver Disease and Hepatitis Program. Patients with definite or probable AIH defined by the International Autoimmune Hepatitis Group (IAHG) criteria provided informed consent for participation in an observational study of AIH. Sera from a study visit were tested for the following autoantibodies: IgG rheumatoid factor (RF) by ELISA, CCP antibody by ELISA, anti-double stranded DNA (dsDNA) by immunofluorescence with Crithidia luciliea and ELISA testing, and anti-nRNP, Sm, Ro, La, and ribosomal P. Rheumatologic diagnoses were determined by medical record review. Diagnoses were documented by a clinical rheumatologist using established criteria, including American College of Rheumatology (ACR) criteria for RA and systemic lupus erythematosus (SLE).
Sera were available from 70 patients with AIH. Of the 70 AIH patients, 66 (94.3%) were female, and the mean age at consent was 52.1 years (SD 18.2, median 56.7). Fourteen AIH patients (20%) had an established rheumatologic diagnosis (9 (12.9%) with RA, and 1 each with SLE, Sjogren's syndrome, mixed connective tissue disease, adult Still's disease, and psoriatic arthritis). In the 9 AIH patients with RA, 5 (55.6%) had RF present, 6 (66.7%) CCP, 5 (55.6%) both RF and CCP, 3 (33.3%) dsDNA, 3 (33.3%) nRNP, 5 (55.6%) Ro, and 2 (22.2%) La. In AIH patients without any known rheumatologic diagnosis (n=56), the most common autoantibody found was dsDNA (26/56, or 46.4%); followed by RF (6/56, or 10.7%), and Ro (6/56, or 10.7%). Other autoantibodies found were CCP in 2 patients, La in 2 patients, and anti-nRNP in 1 patient. No patient with or without a rheumatologic diagnosis had Sm or ribosomal P antibodies.
Antibodies to double stranded DNA are commonly found in Alaska Native patients with AIH, in the absence of diagnosed SLE. This information provides rheumatologists with additional information when considering the differential diagnosis of a positive dsDNA antibody, suggesting that anti-dsDNA is not universally associated with only SLE.
To cite this abstract, please use the following information:
Ferucci, Elizabeth D., Hurlburt, Kathy J., Livingston, Stephen, Plotnik, Julia, Gove, James, McMahon, Brian J., et al; Anti-Double Stranded DNA and Other Autoantibodies Are Common in Alaska Native Autoimmune Hepatitis Patients. [abstract]. Arthritis Rheum 2010;62 Suppl 10 :892