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Volume 39, Number 6, December 2006

Lupus-related advanced liver involvement as the initial presentation of systemic lupus erythematosus


Ming-Chi Lu, Ko-Jen Li, Song-Chou Hsieh, Cheng-Han Wu, Chia-Li Yu
Division of Immunology, Rheumatology and Allergy, DaLin Tzu Chi Buddhist Hospital, Chia-Yi; Division of Immunology, Rheumatology and Allergy, Department of Medicine, Buddhist Tzu Chi General Hospital, Taipei; and Division of Immunology, Rheumatology and Allergy, Department of Medicine, National Taiwan University Hospital, Taipei, Taiwan

Received: August 18, 2005    Revised: April 10, 2006    Accepted: April 14, 2006   

 

Corresponding author:

Song-Chou Hsieh, MD, PhD, Division of Immunology, Rheumatology, and Allergy, Department of Medicine, National Taiwan University Hospital, No 7, Chung-Shan South Road, Taipei, Taiwan. E-mail: songchou@ha.mc.ntu.edu.tw This e-mail address is being protected from spam bots, you need JavaScript enabled to view it

 



 

Background and purpose: 

Systemic lupus erythematosus (SLE), a prototype of systemic autoimmune disease characterized by multiorgan involvement with diverse clinical and serological manifestations, principally affects women in their child-bearing years. Clinically significant hepatic abnormality as the initial presentation of SLE has rarely been reported.

 



 

Methods:

Eleven patients with lupus with initial presentation of lupus-related hepatitis were included in this retrospective review. Clinical manifestation, immunological profiles, and risk factors for poor prognosis were analyzed.

 



 

Results:

The most commonly associated clinical manifestations were found to be thrombocytopenia, leukopenia, advancing age, and presence of anti-SSA/Ro antibody and anti-thyroid antibodies. The diagnosis of SLE was delayed due to dominant hepatic abnormalities. Age greater than 50 years and marked hepatic decompensation in accordance with Child classification B and C might suggest poor prognosis (p=0.06). However, the p value was not statistically significant because of the small sample size.

 



 

Conclusion:

Lupus-related hepatitis, particularly in late-onset lupus, is common. In addition, the presence of anti-SSA, anti-thyroglobulin, and anti-microsomal antibodies is indicative of hepatic involvement in patients with SLE.

 



 

Key words:

Autoantibodies, hepatitis, prognosis, systemic lupus erythematosus


 



 

J Microbiol Immunol Infect 2006;39:471-475.