High-Titre ANA Positivity in NAFLD: An Uncommon Presentation of a Common Disease
  • Asis Mitra
    Ruby General Hospital, Kolkata, India
  • Saswati Ray
    Department of Physiology, Jagannath Gupta Institute of Medical Science and Hospital, Kolkata, India


Antinuclear antibody, non-alcoholic fatty liver disease, autoimmune hepatitis, liver biopsy


Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease and has emerged as a serious public health challenge. About 20% of NAFLD patients may have low titres (<1:320) of antinuclear antibodies (ANA). However, we describe a patient with NAFLD whose ANA titre was high (>1:320) on presentation. After 3 months of diet, exercise and vitamin E supplementation,the patient was symptomatically better but her ANA titre had increased (>1:640). Her liver biopsy showed features of NAFLD with minimal fibrosis. High-titre ANA (>1:320) positivity is rare. Our patient showed a progressive rise in ANA titre from >1:320 to >1:640 within 3 months even though she was improving and histology showed minimal fibrosis.



  • Grygiel-Gorniak B, Rogacka N, Puszczewicz M. Antinuclear antibodies in healthy people and non-rheumatic diseases – diagnostic and clinical implications. Rheumatologia 2018;56(4):243–248.

  • Sumida Y, Eguchi Y, Ono M. Current status and agenda in the diagnosis of nonalcoholic steatohepatitis in Japan. World J Hepatol 2010;2(10):374–383.

  • Rockey DC, Caldwell SH, Goodman ZD, Nelson RC, Smith AD. Liver biopsy. Hepatology 2009;49(3):1017–1044.

  • 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(7):1316–1320.

  • Ravi S, Shoreibah M, Raff E, Bloomer J, Kakati D, Rasheed K, et al. Autoimmune markers do not impact clinical presentation or natural history of steatohepatitis related liver disease. Dig Dis Sci 2015;60(12):3788–3793.

  • Hübscher SG. Histological assessment of non-alcoholic fatty liver disease. Histopathology 2006;49:450–465.

  • Kleiner DE, Brunt EM, Van Natta M, Behling C, Contos MJ, Cummings OW, et al. Design and validation of a histological scoring system for nonalcoholic fatty liver disease. Hepatology 2005;41:1313–1321.
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    Published: 2020-06-08
    Issue: 2020: Vol 7 No 9 (view)

    How to cite:
    Mitra A, Ray S. High-Titre ANA Positivity in NAFLD: An Uncommon Presentation of a Common Disease. EJCRIM 2020;7 doi:10.12890/2020_001714.