Non alkolik steatohepatitli hastalarda antinükleer antikor prevalansı ve önemi

Selim AYDEMİR; İshak Özel TEKİN; Hüseyin ENGİN; Erdem KOÇAK; Ayşe Semra DEMİR; Yücel ÜSTÜNDAĞ

Prevalence and significance of antinuclear antibodies in patients with non-alcoholic steatohepatitis

Year 2005, Volume 4, Issue 3, 158 - 161, 01.12.2005

Selim AYDEMİR İshak Özel TEKİN Hüseyin ENGİN Erdem KOÇAK Ayşe Semra DEMİR Yücel ÜSTÜNDAĞ

Abstract

Background/aim: Antinuclear antibodies (ANA) have been shown in patients with non-alcoholic steatohepatitis (NASH), although their prevalence and significance are uncertain. The aim of this study was to evaluate the prevalence and to determine whether their presence has any biochemical significance. Materials and methods: Laboratory data from 55 patients with a histologic diagnosis of NASH were reviewed retrospectively. ANA were detected by indirect immunofluorescence on HEp2 cells and monkey liver tissue, with a dilutional titer of 1:100 and above considered positive. Results: The mean age of the study population was 43.1±10.4 years. Thirty-eight percent (21/55) of subjects were women. The mean body mass index (BMI) was 29.9±3.1 kg/m2. Twenty-five percent (14/55) of patients with NASH had positive ANA titers. Age, gender, BMI, ALT, AST, GGT, ALP, albumin, total cholesterol, triglycerides and ferritin levels were similar between ANA-positive and negative cases (p>0.05). ANA-positive patients were associated with higher levels of globulin (p

Keywords

Non-alcoholic steatohepatitis, antinuclear antibodies

References

Fong DG, Nehra V, Lindor KD, et al. Metabolic and nutritional con- siderations in nonalcoholic fatty liver. Hepatology 2000; 32: 3-10.
Kumar KS, Malet PF. Nonalcoholic steatohepatitis. Mayo Clin Proc 2000; 75: 733-9.
Matteoni CA, Younossi ZM, Gramlich T, et al. Nonalcoholic fatty li- ver disease: a spectrum of clinical and pathological severity. Gas troenterology 1999; 116: 1413-9.
Yu AS, Keeffe EB. Nonalcoholic fatty liver disease. Rev Gastroente- rol Disord 2002; 2: 11-9.
Ludwig J, Viggiano TR, McGill DB, et al. Nonalcoholic steatohepa- titis: Mayo Clinic experiences with a hitherto unnamed disease. Ma- yo Clin Proc 1980; 55: 434-8.
Lee RG. Nonalcoholic steatohepatitis: a study of 49 patients. Hum Pathol 1989; 20: 594-8.
Powell EE, Cooksley WG, Hanson R, et al. The natural history of nonalcoholic steatohepatitis: a follow-up study of forty-two patients for up to 21 years. Hepatology 1990; 11: 74-80.
Teli MR, James OF, Burt AD, et al. The natural history of nonalco- holic fatty liver: a follow-up study. Hepatology 1995; 22: 1714-9.
Adams LA, Lindor KD, Angulo P. The prevalence of autoantibodies and autoimmune hepatitis in patients with nonalcoholic Fatty liver disease. Am J Gastroenterol 2004; 99: 1316-20.
Czaja AJ, Carpenter HA, Santrach PJ, et al. Genetic predispositions for immunological features in chronic liver diseases other than au- toimmune hepatitis. J Hepatol 1996; 24: 52-9.
Czaja AJ, Homburger HA. Autoantibodies in liver disease. Gastro- enterology 2001; 120: 239-49.
Loria P, Lonardo A, Leonardi F, et al. Non-organ-specific autoan- tibodies in nonalcoholic fatty liver disease: prevalence and correla- tes. Dig Dis Sci 2003; 48: 2173-81.
Bacon BR, Farahvash MJ, Janney CG, et al. Nonalcoholic steatohe- patitis: an expanded clinical entity. Gastroenterology 1994; 107: 1103-9.
Caldwell SH, Oelsner DH, Iezzoni JC, et al. Cryptogenic cirrhosis: clinical characterization and risk factors for underlying disease. Hepatology 1999; 29: 664-9.
Cotler SJ, Kanji K, Keshavarzian A, et al. Prevalence and signifi- cance of autoantibodies in patients with non-alcoholic steatohepati- tis. J Clin Gastroenterol 2004; 38: 801-4.
Czaja AJ, Nishioka M, Morshed SA, et al. Patterns of nuclear immu- nofluorescence and reactivities to recombinant nuclear antigens in autoimmune hepatitis. Gastroenterology 1994; 107: 200-7.
Alvarez F, Berg PA, Bianchi FB, et al. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoim- mune hepatitis. J Hepatol 1999; 31: 929-38.
Bell TM, Bansal AS, Shorthouse C, et al. Low-titre auto-antibodies predict autoimmune disease during interferon-alpha treatment of chronic hepatitis C. J Gastroenterol Hepatol 1999; 14: 419-22.
Homburger HA, Cahen YD, Griffiths J, et al. Detection of antinuc- lear antibodies: comparative evaluation of enzyme immunoassay and indirect immunofluorescence methods. Arch Pathol Lab Med 1998; 122: 993-9.
Lenzi M, Bellentani S, Saccoccio G, et al. Prevalence of non-organ- specific autoantibodies and chronic liver disease in the general po- pulation: a nested case-control study of the Dionysos cohort. Gut 1999; 45: 435-41.
Craig WY, Ledue TB, Johnson AM, et al. The distribution of anti- nuclear antibody titers in "normal" children and adults. J Rheuma- tol 1999; 26: 914-9.
de Vlam K, De Keyser F, Verbruggen G, et al. Detection and iden- tification of antinuclear autoantibodies in the serum of normal blo- od donors. Clin Exp Rheumatol 1993; 11: 393-7.
Fritzler MJ, Pauls JD, Kinsella TD, et al. Antinuclear, anticytoplas- mic, and anti-Sjogren's syndrome antigen A (SS-A/Ro) antibodies in female blood donors. Clin Immunol Immunopathol 1985; 36: 120- 8.
Spiewak R, Stojek N. Antinuclear antibodies among eastern-Polish rural inhabitants. Ann Agric Environ Med 2003; 10: 207-9.
Cassani F, Cataleta M, Valentini P, et al. Serum autoantibodies in chronic hepatitis C: comparison with autoimmune hepatitis and im- pact on the disease profile. Hepatology 1997; 26: 561-6.