Document Detail


Liver involvement in systemic lupus erythematosus: incidence, clinical course and outcome of lupus hepatitis.
MedLine Citation:
PMID:  20609296     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aims of this study were to assess the spectrum of liver disease occurring in systemic lupus erythematosus (SLE), primarily the incidence, clinical course and outcome of lupus hepatitis (LH).
METHODS: The records of 283 SLE out-patients referred to our Unit between 1994 and 2008 were reviewed to identify clinical or laboratory evidence of liver involvement. Liver enzyme values were considered abnormal when a sustained increase in serum transaminase levels above the normal value was observed for a period of at least three months or when the increase was confirmed in two consecutive assessments. Study inclusion criteria were a follow-up of at least 12 months and three liver function tests per year over the course of disease.
RESULTS: A total of 242 patients with a mean follow-up of 72.2+/-59.1 months were identified. Liver enzyme abnormalities were observed in 45 (18.6%) patients. Of these, only 14 cases (5.8%) could be attributed to LH. Clinical course and response to therapy enabled the identification of three different patterns: remitting, unremitting and relapsing forms. Acute hepatitis and liver failure were not observed. Low serum alanine transaminase levels at diagnosis and high doses of prednisone were associated to resolution of LH. Clinical course or response to therapy did not appear to be affected by liver histology or serological findings.
CONCLUSIONS: LH is generally sub-clinical with a fluctuating course and responds well to moderate to high doses of prednisone without progression to end-stage liver disease.
Authors:
M Piga; A Vacca; G Porru; A Cauli; A Mathieu
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Publication Detail:
Type:  Journal Article     Date:  2010-08-30
Journal Detail:
Title:  Clinical and experimental rheumatology     Volume:  28     ISSN:  0392-856X     ISO Abbreviation:  Clin. Exp. Rheumatol.     Publication Date:    2010 Jul-Aug
Date Detail:
Created Date:  2010-09-02     Completed Date:  2010-12-02     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8308521     Medline TA:  Clin Exp Rheumatol     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  504-10     Citation Subset:  IM    
Affiliation:
Chair of Rheumatology and Rheumatology Unit, University and AOU of Cagliari, Cagliari, Italy. matteopiga@alice.it
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adrenal Cortex Hormones / therapeutic use
Adult
Alanine Transaminase / blood
Child
Cohort Studies
Female
Humans
Incidence
Italy
Kaplan-Meier Estimate
Liver / enzymology,  physiopathology
Liver Diseases / diagnosis*,  drug therapy,  epidemiology*
Liver Function Tests
Lupus Erythematosus, Systemic / complications*
Male
Middle Aged
Prednisone / therapeutic use
Prognosis
Retrospective Studies
Young Adult
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 53-03-2/Prednisone; EC 2.6.1.2/Alanine Transaminase

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