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The records of 89 patients with hepatitis B surface antigen, negative severe chronic active hepatitis and antinuclear antibody (ANA) positivity were reviewed to assess the degree of clinical similarity between this disorder and systemic lupus erythematosus (SLE). Although immunologic abnormalities, such as antibodies to native DNA and positive lupus erythematosus cell preparations were common, few patients with ANA positive chronic active hepatitis had clinical features to suggest SLE. The 1971 preliminary criteria and the 1982 revision of the American Rheumatism Association criteria for classification of SLE were 93 and 91% specific, respectively. We conclude that despite laboratory similarities, ANA positive chronic active hepatitis and SLE differ substantially in their clinical presentations.
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