Anti-nucleosome antibodies demonstrated the highest diagnostic accuracy in this subgroup (area under the curve (AUROC): 0.85; 95 % CI: 0.70-1.00), outperforming or equaling Immunoglobulin G (IgG) (AUROC: 0.85; 95 % CI: 0.74, 0.95), anti-F-actin antibodies (AUROC: 0.81; 95 % CI: 0.69, 0.93) and anti-smooth muscle antibodies (SMA) (AUROC: 0.80; 95 % CI: 0.67, 0.92).<h4>Conclusions</h4>In ANA-positive patients with a homogeneous ANA pattern, anti-nucleosome antibodies provide high diagnostic accuracy in distinguishing AIH from DILI. Here, SMN1 is linked to autoimmune hepatitis.