Liver involvement in patients with systemic lupus erythematosus
Liver involvement in systemic lupus erythematosus is common and in most cases clinical course is asymptomatic, that makes diagnosis difficult. Determination of the cause of the liver involvement is important to select treatment and to evaluate the prognosis of the disease.The aim of the research was...
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IMA PRESS LLC
2021-05-01
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| Series: | Научно-практическая ревматология |
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| author | A. P. Panova V. G. Avdeev T. N. Krasnova T. P. Rozina E. P. Pavlikova O. A. Georginova A. L. Filatova E. N. Borisov P. I. Novikov |
| author_facet | A. P. Panova V. G. Avdeev T. N. Krasnova T. P. Rozina E. P. Pavlikova O. A. Georginova A. L. Filatova E. N. Borisov P. I. Novikov |
| author_sort | A. P. Panova |
| collection | DOAJ |
| description | Liver involvement in systemic lupus erythematosus is common and in most cases clinical course is asymptomatic, that makes diagnosis difficult. Determination of the cause of the liver involvement is important to select treatment and to evaluate the prognosis of the disease.The aim of the research was to characterize the clinical features of liver involvement in patients with systemic lupus erythematosus and identify the most significant clinical and laboratory parameters for the differential diagnosis of lupus hepatitis.Materials and methods. The study included 313 patients with systemic lupus erythematosus observed in the E.M. Tareev Clinic of Rheumatology, Internal Medicine and Occupational Diseases of I.M. Sechenov First Moscow State Medical University (Sechenov University) in the period from 2001 to 2019. The verification of diagnosis of systemic lupus erythematosus was based on the criteria of the American College of Rheumatology (1997). Patients examination included complete blood count, biochemical and immunological blood tests and an abdominal ultrasonography. In 13 cases hepatic autoantibodies (ASMA, anti-LKM-1, LC-1, SLA-LP, AMA-M2) were analyzed, in 4 – magnetic resonance cholangiopancreatography and in 6 – liver biopsy were made.Results. Liver involvement were represented by an increase of liver enzymes in 58 (18.5%) cases. Chronic viral hepatitis C was diagnosed in 4 (1.3%) patients. Drug-induced hepatitis was found in 17 (5.4%) patients. Autoimmune liver diseases occured in 2 (0.6%) patients. In 2 (0.6%) patients, liver damage was associated with thrombotic microangiopathy (atypical hemolytic uremic syndrome, hereditary thrombophilia). In 15 (4.8%) cases, the most likely diagnosis was NAFLD. Lupus hepatitis was the most likely cause in 18 (5.7%) patients. Differential diagnosis in cases of liver involvement in patients with systemic lupus erythematosus requires assessment of risk factors for various liver diseases, age of the patients, level of liver enzymes, lupus activity, ultrasound signs of liver steatosis and secondary antiphospholipid syndrome.Determining the cause of the liver involvement for the patients with the systemic lupus erythematosus allows establishing better treatment tactic and improvement of the prognosis. |
| format | Article |
| id | doaj-art-509733c106fb4220bf546500565237fc |
| institution | DOAJ |
| issn | 1995-4484 1995-4492 |
| language | Russian |
| publishDate | 2021-05-01 |
| publisher | IMA PRESS LLC |
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| series | Научно-практическая ревматология |
| spelling | doaj-art-509733c106fb4220bf546500565237fc2025-08-20T03:22:13ZrusIMA PRESS LLCНаучно-практическая ревматология1995-44841995-44922021-05-0159216417210.47360/1995-4484-2021-164-1722699Liver involvement in patients with systemic lupus erythematosusA. P. Panova0V. G. Avdeev1T. N. Krasnova2T. P. Rozina3E. P. Pavlikova4O. A. Georginova5A. L. Filatova6E. N. Borisov7P. I. Novikov8Lomonosov Moscow State UniversityLomonosov Moscow State UniversityLomonosov Moscow State University; I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)Lomonosov Moscow State University; I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)Lomonosov Moscow State UniversityLomonosov Moscow State UniversityLomonosov Moscow State University; I.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)Lomonosov Moscow State UniversityI.M. Sechenov First Moscow State Medical University of the Ministry of Health Care of Russian Federation (Sechenov University)Liver involvement in systemic lupus erythematosus is common and in most cases clinical course is asymptomatic, that makes diagnosis difficult. Determination of the cause of the liver involvement is important to select treatment and to evaluate the prognosis of the disease.The aim of the research was to characterize the clinical features of liver involvement in patients with systemic lupus erythematosus and identify the most significant clinical and laboratory parameters for the differential diagnosis of lupus hepatitis.Materials and methods. The study included 313 patients with systemic lupus erythematosus observed in the E.M. Tareev Clinic of Rheumatology, Internal Medicine and Occupational Diseases of I.M. Sechenov First Moscow State Medical University (Sechenov University) in the period from 2001 to 2019. The verification of diagnosis of systemic lupus erythematosus was based on the criteria of the American College of Rheumatology (1997). Patients examination included complete blood count, biochemical and immunological blood tests and an abdominal ultrasonography. In 13 cases hepatic autoantibodies (ASMA, anti-LKM-1, LC-1, SLA-LP, AMA-M2) were analyzed, in 4 – magnetic resonance cholangiopancreatography and in 6 – liver biopsy were made.Results. Liver involvement were represented by an increase of liver enzymes in 58 (18.5%) cases. Chronic viral hepatitis C was diagnosed in 4 (1.3%) patients. Drug-induced hepatitis was found in 17 (5.4%) patients. Autoimmune liver diseases occured in 2 (0.6%) patients. In 2 (0.6%) patients, liver damage was associated with thrombotic microangiopathy (atypical hemolytic uremic syndrome, hereditary thrombophilia). In 15 (4.8%) cases, the most likely diagnosis was NAFLD. Lupus hepatitis was the most likely cause in 18 (5.7%) patients. Differential diagnosis in cases of liver involvement in patients with systemic lupus erythematosus requires assessment of risk factors for various liver diseases, age of the patients, level of liver enzymes, lupus activity, ultrasound signs of liver steatosis and secondary antiphospholipid syndrome.Determining the cause of the liver involvement for the patients with the systemic lupus erythematosus allows establishing better treatment tactic and improvement of the prognosis.https://rsp.mediar-press.net/rsp/article/view/3019systemic lupus erythematosuslupus hepatitisnon-alcoholic fatty liver diseaseantiphospholipid syndrome |
| spellingShingle | A. P. Panova V. G. Avdeev T. N. Krasnova T. P. Rozina E. P. Pavlikova O. A. Georginova A. L. Filatova E. N. Borisov P. I. Novikov Liver involvement in patients with systemic lupus erythematosus Научно-практическая ревматология systemic lupus erythematosus lupus hepatitis non-alcoholic fatty liver disease antiphospholipid syndrome |
| title | Liver involvement in patients with systemic lupus erythematosus |
| title_full | Liver involvement in patients with systemic lupus erythematosus |
| title_fullStr | Liver involvement in patients with systemic lupus erythematosus |
| title_full_unstemmed | Liver involvement in patients with systemic lupus erythematosus |
| title_short | Liver involvement in patients with systemic lupus erythematosus |
| title_sort | liver involvement in patients with systemic lupus erythematosus |
| topic | systemic lupus erythematosus lupus hepatitis non-alcoholic fatty liver disease antiphospholipid syndrome |
| url | https://rsp.mediar-press.net/rsp/article/view/3019 |
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