High frequency of anti-ribosomal P antibody in patients with systemic lupus erythematosus-associated hepatitis.

Hepatic manifestations are a common phenomenon in patients with systemic lupus erythematosus (SLE). However, their cause may be difficult clinically to determine. A significantly increased frequency of anti-ribosomal P antibody has recently been found in patients with SLE-associated hepatitis. Thus, we examined the prevalence of anti-ribosomal P antibody and clinical differences between anti-ribosomal P antibody positive and negative SLE patients with liver dysfunction using ELISA kits against recombinant ribosomal P0 protein. Sera of 61 patients with SLE and 20 patients with autoimmune hepatitis (AIH) were assayed. Of 34 SLE patients with liver dysfunction, anti-ribosomal P antibody was detected in 15 (44.1%), consisting of 11 (68.8%) of 16 patients with SLE-associated hepatitis, 2 (28.6%) of 7 patients with fatty liver, 1 (16.7%) of 6 patients with drug-induced hepatitis, and 1 (20.0%) of 5 patients with SLE complicated by AIH. This antibody was not detected in patients with AIH. Except for those with SLE-associated hepatitis, anti-ribosomal P antibody positive patients were complicated by renal dysfunction and CNS lupus. The positive rate of anti-ribosomal P antibody was significantly higher in patients with SLE-associated hepatitis (68.8%) than in patients with SLE complicated by AIH (20%) ( [Formula: see text] ) and AIH (0%) ( [Formula: see text] ). These findings suggest that anti-ribosomal P antibody may be a useful marker of SLE-associated hepatitis to differentiate it from AIH and other liver dysfunctions in SLE patients without renal dysfunction or CNS lupus.