Immunomorphological characterisation of antinuclear antibodies in chronic liver disease

Two immunofluorescence procedures to evaluate antinuclear antibodies were compared in a series of 221 patients with chronic liver disorders of various aetiologies. The use of HEp-2 cells allowed us to discriminate with more confidence between the homogeneous and speckled patterns, to show the presence of associated patterns in the same serum, and, above all, to identify two specificities, unrecognizable on tissue sections. The anticentromere antibody was found in 10% of cases of primary biliary cirrhosis and occasionally in other conditions; the antibody staining multiple nuclear dots was strictly confined to primary biliary cirrhosis (17%). With the exception of autoimmune chronic active hepatitis the prevalence of antinuclear antibodies increased in all groups, particularly in primary biliary cirrhosis. Homogeneous antinuclear antibody was associated by both immunofluorescence procedures with autoimmune chronic active hepatitis. The multiple nuclear dot antinuclear antibody turned out to be an additional marker of primary biliary cirrhosis, helpful for the positive diagnosis of primary biliary cirrhosis in a proportion of cases negative for antimitochondrial antibody. Absorption experiments showed that multiple nuclear dot and antimitochondrial antibody are antigenically distinct. Moreover, multiple nuclear dot antinuclear antibody was associated with the finding of a dry Schirmer's test.