Liver abnormalities in rheumatic diseases
Department of Medicine, Division of Rheumatology; Meyers Primary Care Institute
Medical Subject Headings
Anti-Inflammatory Agents, Non-Steroidal; Arthritis, Rheumatoid; Biopsy; Felty's Syndrome; Hemochromatosis; Humans; Liver; Liver Diseases; Rheumatic Diseases; Scleroderma, Systemic; Spondylitis, Ankylosing; Still's Disease, Adult-Onset
Health Services Research | Primary Care | Rheumatology
Abnormalities of LFTs and liver function occur not infrequently in patients with rheumatic conditions, and many diagnostic possibilities exist. Systemic inflammation that is related to uncontrolled rheumatic disease and periods of disease remission have been described as a cause for fluctuations in levels of serum aminotransferases. Although these benign extra-articular manifestations of rheumatic disease are the most common manifestations, more serious hepatic involvement, including vasculitis, nodular regenerative hyperplasia, and primary biliary cirrhosis, have been observed in specific rheumatic diseases. The cause of rheumatic disease is unclear. Occult HCV infection and associated cryoglobulinemia can mimic rheumatic disease. HCV infection should be suspected routinely in patients with mixed cryoglobulinemia, especially because antiviral therapy may be beneficial. The medical management of rheumatic disease involves medications that are often hepatotoxic. Routine laboratory monitoring, imaging studies, and, if necessary, biopsy examination in situations in which serum aminotransferases remain abnormal, are recommended.
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Citation: Clin Liver Dis. 2002 Nov;6(4):933-46.
Walker, Nancy J. and Zurier, Robert B., "Liver abnormalities in rheumatic diseases" (2002). Meyers Primary Care Institute Publications and Presentations. 299.