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Published in: Rheumatology International 9/2012

01-09-2012 | Case Report

Late-onset systemic lupus erythematosus-associated liver disease

Authors: Leonardo L. Schiavon, Roberto J. Carvalho-Filho, Janaína Luz Narciso-Schiavon, Valéria P. Lanzoni, Maria Lucia G. Ferraz, Antonio Eduardo B. Silva

Published in: Rheumatology International | Issue 9/2012

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Abstract

Systemic lupus erythematosus (SLE) is a multisystemic autoimmune disease, which predominantly affects women under 50 years old. Although liver disease is not included in the diagnostic criteria, abnormal liver tests are common among patients with SLE and, in a significant proportion of those patients, no other underlying condition can be identified. We described a case of liver involvement in late-onset SLE presenting with a predominantly cholestatic pattern. Other conditions associated with abnormal liver tests were excluded, and the patient showed a prompt response to steroid therapy. The spectrum of the liver involvement in SLE is discussed, with emphasis on the differential diagnosis with autoimmune hepatitis.
Literature
1.
go back to reference Reeves GE (2004) Update on the immunology, diagnosis and management of systemic lupus erythematosus. Intern Med J 34:338–347PubMedCrossRef Reeves GE (2004) Update on the immunology, diagnosis and management of systemic lupus erythematosus. Intern Med J 34:338–347PubMedCrossRef
2.
go back to reference Runyon BA, LaBrecque DR, Anuras S (1980) The spectrum of liver disease in systemic lupus erythematosus. Report of 33 histologically-proved cases and review of the literature. Am J Med 69:187–194PubMedCrossRef Runyon BA, LaBrecque DR, Anuras S (1980) The spectrum of liver disease in systemic lupus erythematosus. Report of 33 histologically-proved cases and review of the literature. Am J Med 69:187–194PubMedCrossRef
3.
go back to reference Miller MH, Urowitz MB, Gladman DD, Blendis LM (1984) The liver in systemic lupus erythematosus. Q J Med 53:401–409PubMed Miller MH, Urowitz MB, Gladman DD, Blendis LM (1984) The liver in systemic lupus erythematosus. Q J Med 53:401–409PubMed
4.
go back to reference van Hoek B (1996) The spectrum of liver disease in systemic lupus erythematosus. Neth J Med 48:244–253PubMedCrossRef van Hoek B (1996) The spectrum of liver disease in systemic lupus erythematosus. Neth J Med 48:244–253PubMedCrossRef
5.
go back to reference Koh ET, Boey ML (1994) Late onset lupus: a clinical and immunological study in a predominantly Chinese population. J Rheumatol 21:1463–1467PubMed Koh ET, Boey ML (1994) Late onset lupus: a clinical and immunological study in a predominantly Chinese population. J Rheumatol 21:1463–1467PubMed
6.
go back to reference Pahissa A, Marti S, Martinez-Vazquez JM, Guardia J (1981) Systemic lupus erythematosus with late clinical onset (author’s transl). Med Clin (Barc) 76:299–302 Pahissa A, Marti S, Martinez-Vazquez JM, Guardia J (1981) Systemic lupus erythematosus with late clinical onset (author’s transl). Med Clin (Barc) 76:299–302
7.
go back to reference Youssef WI, Tavill AS (2002) Connective tissue diseases and the liver. J Clin Gastroenterol 35:345–349PubMedCrossRef Youssef WI, Tavill AS (2002) Connective tissue diseases and the liver. J Clin Gastroenterol 35:345–349PubMedCrossRef
8.
go back to reference Boumpas DT, Austin HA 3rd, Fessler BJ, Balow JE, Klippel JH, Lockshin MD (1995) Systemic lupus erythematosus: emerging concepts. Part 1: renal, neuropsychiatric, cardiovascular, pulmonary, and hematologic disease. Ann Intern Med 122:940–950PubMed Boumpas DT, Austin HA 3rd, Fessler BJ, Balow JE, Klippel JH, Lockshin MD (1995) Systemic lupus erythematosus: emerging concepts. Part 1: renal, neuropsychiatric, cardiovascular, pulmonary, and hematologic disease. Ann Intern Med 122:940–950PubMed
9.
go back to reference Boumpas DT, Fessler BJ, Austin HA 3rd, Balow JE, Klippel JH, Lockshin MD (1995) Systemic lupus erythematosus: emerging concepts. Part 2: dermatologic and joint disease, the antiphospholipid antibody syndrome, pregnancy and hormonal therapy, morbidity and mortality, and pathogenesis. Ann Intern Med 123:42–53PubMed Boumpas DT, Fessler BJ, Austin HA 3rd, Balow JE, Klippel JH, Lockshin MD (1995) Systemic lupus erythematosus: emerging concepts. Part 2: dermatologic and joint disease, the antiphospholipid antibody syndrome, pregnancy and hormonal therapy, morbidity and mortality, and pathogenesis. Ann Intern Med 123:42–53PubMed
10.
go back to reference Sanchez-Urdazpal L, Czaja AJ, van Hoek B, Krom RA, Wiesner RH (1992) Prognostic features and role of liver transplantation in severe corticosteroid-treated autoimmune chronic active hepatitis. Hepatology 15:215–221PubMedCrossRef Sanchez-Urdazpal L, Czaja AJ, van Hoek B, Krom RA, Wiesner RH (1992) Prognostic features and role of liver transplantation in severe corticosteroid-treated autoimmune chronic active hepatitis. Hepatology 15:215–221PubMedCrossRef
11.
go back to reference Hall S, Czaja AJ, Kaufman DK, Markowitz H, Ginsburg WW (1986) How lupoid is lupoid hepatitis? J Rheumatol 13:95–98PubMed Hall S, Czaja AJ, Kaufman DK, Markowitz H, Ginsburg WW (1986) How lupoid is lupoid hepatitis? J Rheumatol 13:95–98PubMed
12.
go back to reference Gurian LE, Rogoff TM, Ware AJ, Jordan RE, Combes B, Gilliam JN (1985) The immunologic diagnosis of chronic active “autoimmune” hepatitis: distinction from systemic lupus erythematosus. Hepatology 5:397–402PubMedCrossRef Gurian LE, Rogoff TM, Ware AJ, Jordan RE, Combes B, Gilliam JN (1985) The immunologic diagnosis of chronic active “autoimmune” hepatitis: distinction from systemic lupus erythematosus. Hepatology 5:397–402PubMedCrossRef
14.
go back to reference Van Hoek B, Kallenberg CGM, Limburg PC (1989) Anticardiolipin antibodies in chronic active hepatitis: no correlation with anti-ds DNA antibodies and no association with thrombo-embolism [abstract]. Hepatology 10:686 Van Hoek B, Kallenberg CGM, Limburg PC (1989) Anticardiolipin antibodies in chronic active hepatitis: no correlation with anti-ds DNA antibodies and no association with thrombo-embolism [abstract]. Hepatology 10:686
15.
go back to reference Ohira H, Takiguchi J, Rai T, Abe K, Yokokawa J, Sato Y et al (2004) High frequency of anti-ribosomal P antibody in patients with systemic lupus erythematosus-associated hepatitis. Hepatol Res 28:137–139PubMedCrossRef Ohira H, Takiguchi J, Rai T, Abe K, Yokokawa J, Sato Y et al (2004) High frequency of anti-ribosomal P antibody in patients with systemic lupus erythematosus-associated hepatitis. Hepatol Res 28:137–139PubMedCrossRef
16.
go back to reference Tojo J, Ohira H, Abe K, Yokokawa J, Takiguchi J, Rai T et al (2004) Autoimmune hepatitis accompanied by systemic lupus erythematosus. Intern Med 43:258–262PubMedCrossRef Tojo J, Ohira H, Abe K, Yokokawa J, Takiguchi J, Rai T et al (2004) Autoimmune hepatitis accompanied by systemic lupus erythematosus. Intern Med 43:258–262PubMedCrossRef
17.
go back to reference Michel F, Toussirot E, Wendling D (1998) Primary biliary cirrhosis and systemic lupus erythematosus. A new case report. Rev Rhum Engl Ed 65:504–507PubMed Michel F, Toussirot E, Wendling D (1998) Primary biliary cirrhosis and systemic lupus erythematosus. A new case report. Rev Rhum Engl Ed 65:504–507PubMed
18.
go back to reference Islam S, Riordan JW, McDonald JA (1999) Case report: a rare association of primary biliary cirrhosis and systemic lupus erythematosus and review of the literature. J Gastroenterol Hepatol 14:431–435PubMedCrossRef Islam S, Riordan JW, McDonald JA (1999) Case report: a rare association of primary biliary cirrhosis and systemic lupus erythematosus and review of the literature. J Gastroenterol Hepatol 14:431–435PubMedCrossRef
19.
go back to reference Chowdhary VR, Crowson CS, Poterucha JJ, Moder KG (2008) Liver involvement in systemic lupus erythematosus: case review of 40 patients. J Rheumatol 35:2159–2164PubMedCrossRef Chowdhary VR, Crowson CS, Poterucha JJ, Moder KG (2008) Liver involvement in systemic lupus erythematosus: case review of 40 patients. J Rheumatol 35:2159–2164PubMedCrossRef
20.
go back to reference Heyman SN, Spectre G, Aamar S, Rubinger D, Pappo O, Ackerman Z (2002) Autoimmune cholangiopathy associated with systemic lupus erythematosus. Liver 22:102–106PubMedCrossRef Heyman SN, Spectre G, Aamar S, Rubinger D, Pappo O, Ackerman Z (2002) Autoimmune cholangiopathy associated with systemic lupus erythematosus. Liver 22:102–106PubMedCrossRef
21.
go back to reference Atsumi T, Sagawa A, Jodo S, Amasaki Y, Nakabayashi T, Ohnishi K et al (1995) Severe hepatic involvement without inflammatory changes in systemic lupus erythematosus: report of two cases and review of the literature. Lupus 4:225–228PubMedCrossRef Atsumi T, Sagawa A, Jodo S, Amasaki Y, Nakabayashi T, Ohnishi K et al (1995) Severe hepatic involvement without inflammatory changes in systemic lupus erythematosus: report of two cases and review of the literature. Lupus 4:225–228PubMedCrossRef
Metadata
Title
Late-onset systemic lupus erythematosus-associated liver disease
Authors
Leonardo L. Schiavon
Roberto J. Carvalho-Filho
Janaína Luz Narciso-Schiavon
Valéria P. Lanzoni
Maria Lucia G. Ferraz
Antonio Eduardo B. Silva
Publication date
01-09-2012
Publisher
Springer-Verlag
Published in
Rheumatology International / Issue 9/2012
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI
https://doi.org/10.1007/s00296-010-1492-4

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