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Liver abnormalities in rheumatic diseases.

Nancy J Walker¹, Robert B Zurier

¹Division of Rheumatology, University of Massachusetts Medical School, 55 Lake Avenue, North Worcester, MA 01655, USA. walkern@ummhc.org

Clinics in Liver Disease

|January 9, 2003

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Abnormal liver function tests (LFTs) are common in rheumatic diseases due to inflammation or medications. Investigating causes like Hepatitis C virus (HCV) infection is crucial for effective treatment.

Area of Science:

Rheumatology
Hepatology
Immunology

Background:

Abnormal liver function tests (LFTs) are frequent in rheumatic conditions.
Causes range from systemic inflammation to serious hepatic involvement like vasculitis.
Occult Hepatitis C virus (HCV) infection can mimic rheumatic diseases.

Purpose of the Study:

To review the causes and diagnostic possibilities of abnormal LFTs in rheumatic diseases.
To highlight the importance of considering HCV infection in patients with cryoglobulinemia.
To emphasize the need for monitoring and investigation of persistent aminotransferase abnormalities.

Main Methods:

Literature review of studies on rheumatic diseases and liver involvement.
Discussion of diagnostic approaches for abnormal LFTs.

Related Experiment Videos

Emphasis on clinical suspicion and laboratory monitoring.

Main Results:

Systemic inflammation and disease remission can cause aminotransferase fluctuations.
Serious hepatic conditions like nodular regenerative hyperplasia and primary biliary cirrhosis are associated with specific rheumatic diseases.
HCV infection, particularly with cryoglobulinemia, requires consideration due to potential benefits of antiviral therapy.

Conclusions:

Abnormal LFTs in rheumatic patients necessitate a broad differential diagnosis.
Hepatotoxicity from medications used to treat rheumatic diseases is a common concern.
Routine monitoring and appropriate investigations, including for HCV, are essential for managing liver health in rheumatic disease patients.