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Chronic hepatitis during rheumatoid arthritis.

C Job-Deslandre1, J L Feldmann, Y Djian

  • 1Service de Rhumatologie A, Hôpital Cochin, Paris, France.

Clinical and Experimental Rheumatology
|September 1, 1991
PubMed
Summary

Rheumatoid arthritis (RA) can be associated with chronic hepatitis, a rare condition. This study reports six female cases, highlighting clinical, biological, and histological findings, and the potential benefits of steroid therapy for this RA complication.

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Area of Science:

  • Hepatology
  • Rheumatology
  • Immunology

Background:

  • Chronic hepatitis is an uncommon complication of rheumatoid arthritis (RA), reported in only 1.9% of cases.
  • The association between RA and chronic liver disease warrants further investigation due to potential shared autoimmune mechanisms.

Purpose of the Study:

  • To report and analyze six cases of chronic hepatitis associated with rheumatoid arthritis.
  • To describe the clinical presentation, laboratory findings, histological features, and treatment outcomes in patients with this dual diagnosis.

Main Methods:

  • Retrospective case series analysis of six patients diagnosed with rheumatoid arthritis and chronic hepatitis.
  • Review of patient demographics, clinical history, serological markers (rheumatoid factor, antinuclear antibodies, anti-smooth muscle antibodies), liver function tests, and liver biopsy results.

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  • Evaluation of treatment response to steroid therapy.

    • Main Results:

    • All six patients were female with a mean age of 59.5 years, presenting with typical RA and sicca syndrome in five cases.
    • Chronic hepatitis developed after RA onset, with laboratory findings including elevated transaminases, increased alkaline phosphatase in three cases, and liver insufficiency in four.
    • Liver biopsies revealed active chronic hepatitis in five patients (three with cirrhosis) and persistent chronic hepatitis in one. Steroid therapy improved outcomes in four patients.

    Conclusions:

    • Chronic hepatitis is a rare but significant association with rheumatoid arthritis, characterized by specific serological and histological findings.
    • Early diagnosis and management, potentially including steroid therapy, may improve clinical and biological outcomes in patients with RA-associated chronic hepatitis.
    • Further research is needed to elucidate the underlying pathogenesis and optimize treatment strategies for this rare condition.