Autoimmune diseases are marked by the presence of more or less specific autoantibodies for each of them. The detection and identification of these autoantibodies seem to be the pillars of the diagnosis. The aim of our study is to evaluate the ELISA technique compared to the immunodot, for the detection of extractable nuclear antigens antibodies Sm, SSA and SSB. This is a retrospective, comparative study of biological diagnostic techniques carried out over 6 months. 86 sera from patients tested by the immunodot for the detection of extractable nuclear antigens antibodies were analyzed by an ELISA test (AESKULISA) for the detection of anti-Sm, anti-SSA and anti-SSB antibodies. Sensitivities, specificities, PPVs, NPVs and the correlation index were calculated respectively for each of the three kits AESKULISA Sm (57.14%, 97.46%, 66.6%, 97.46%, 94%), AESKULISA SSA (53.84 %, 97.87%, 95.45%, 71.87%, 77.90%) and AESKULISA SSB (16.66%, 100%, 100%, 81.92%, 82.55%). Our study found low levels of sensitivity of the ELISA technique compared to the immunodot, which could be explained by the nature of the antigenic substrates, the coating procedures and the cut-off levels used by kits manufacturers. The immunodot appears to be more sensitive and more specific for the detection of anti-SSB antibodies and more sensitive for the detection of anti-SSA 52kDa antibodies. Indeed, a combination of two or more methods is to be recommended in order to optimize the relevance of the diagnostic test for the screening of anti-ENA antibodies.

Purpose: The hepatitis C-Auto-immune hepatitis overlap syndrome is an uncommon condition whose management can be difficult in both diagnosis and treatment. Patients et méthodes: 62 old years women, without particular history Hepatitis C was proven by a positive HCV viral load and the autoimmune hepatitis was proven by characteristic immunological and/or histological features.Liver function tests was prescribed. Search for hepatitis B and C viral markers was performed by chimiluminescence, the viral load of the virus VHC was performed by molecular biology. The nuclear anti body were detected by indirect immunofluorescence on hep cells 20-10.Solubles antigens was performed by dot blot Résults: Laboratory studies showed a lever transaminase ALAT at 220 UI /l, ASAT at 231 UI /l, hypergammaglobulineamia at 30g/l, HVC seropositive, high viral load at 6.19 106 UI/ml. The nuclear antibody showed cytoplasmic fluorescence, Anti DNA were negative, liver biobsy showed lymphocytic infiltrates and steatosis Conclusion: This case illustrates diagnostic and therapeutic difficulties of hepatitis C–AIH overlap syndromes, this study highlights the deciding contribution of the initial histological findings in the diagnosis of such a HCV/autoimmune hepatitis overlap syndrome.