Clinical Features Of Liver Disturbance In Rheumatoid Disease

[Guest guest]

Clinical Features Of Liver Disturbance In Rheumatoid Disease

Journal of Gastroenterology

09/24/2002

By Loshak

The chief cause of liver disturbance in patients with rheumatoid diseases is

liver disease itself.

But in such cases, the liver disturbance is mild and transient, whereas

progressive liver diseases are often associated with hepatotropic virus or

autoimmune liver conditions.

Liver histology is therefore indispensable for differentiating autoimmune

hepatitis from liver disease associated with rheumatoid diseases, say

investigators at Nara Medical University, Kashihara, Japan.

They noted that liver disturbance in rheumatoid diseases resulted from

several causes besides associated liver disease.

This led them to look into the causes of liver disturbance in 306 patients.

Of these, 106 had systemic lupus erythematosus. Other conditions were

Sjögren's syndrome (n=71), rheumatoid arthritis (n=59), scleroderma (n=27),

polymyositis (n=30) and polyarteritis nodosa (n=13).

The causes of liver disturbance, which affected 43 percent of the 306

patients, varied in both degree and duration, the investigators reported.

Liver disease associated with rheumatoid diseases, the leading cause of

liver disturbance, was characterised by mild and transient liver

disturbance. The maximum alanine aminotransferase level was 68 ± 8 IU/ml,

the maximum alkaline phosphatase level 410 ± 31 IU/ml and the duration of

liver disturbance 6.0±2.0 months.

Most patients with this type of liver disease showed minimal change in liver

histology. Two-thirds of those evaluated by the international scoring system

for autoimmune hepatitis were classified as " probable " or " definite " .

Of 14 patients with histologically proven chronic hepatitis or cirrhosis,

eight were infected with hepatotropic virus (seven with hepatitis C and one

with hepatitis B virus).

Of nine patients in whom the hepatic lesion progressed, five had

hepatotropic virus infection (four with hepatitis C and one with hepatitis B

virus). The remaining four had autoimmune liver diseases.

Journal of Gastroenterology 2002;37(8):617-625