Rheumatic diseases and the liver

Abstract

Rheumatic diseases affect multiple organs, including the liver. Liver dysfunction is not rare in patients with rheumatic diseases. Not only rheumatic disease itself, but also other factors such as drug toxicity, virus, fatty infiltration and overlapping autoimmune liver disease can cause liver dysfunction. Therefore, liver dysfunction in patients with collagen diseases needs to be considered separately from the rheumatic disease itself and other causes. Liver dysfunction in patients with rheumatic disease is tended to be mild and temporary, so the causes are often overlooked. However, acute liver failure occurs infrequently by some causes such as de novo hepatitis B or adult-onset Still’s disease. Liver dysfunction in patients with rheumatic disease shows relatively specific tendencies for each collagen disease. On the other hand, liver dysfunction caused by systemic lupus erythematosus (SLE) itself is difficult to distinguish from autoimmune hepatitis (AIH) because of the laboratory findings are similar. Histological examination of the liver is useful for differentially diagnosing AIH and SLE-associated hepatitis. The feature of liver dysfunction and its causes need to be elucidated and considered when treating rheumatic diseases.