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Liver involvement in subjects with rheumatic disease
Carlo Selmi1, Maria De Santis, M Eric Gershwin
1Department of Medicine and Autoimmunity and Metabolism Unit, IRCCS-Istituto Clinico Humanitas, University of Milan, via. A. Manzoni 56, 20089 Rozzano (MI), Italy.
Arthritis Research & Therapy
|July 5, 2011
Summary
The liver is often overlooked in rheumatology, but clinicians must monitor for liver injury from autoimmune diseases, direct parenchymal involvement, or treatments like methotrexate. Awareness of immunosuppression
Area of Science:
- Rheumatology
- Hepatology
- Clinical Medicine
Background:
- The liver is frequently an overlooked target organ in systemic rheumatic diseases.
- Liver pathology can be secondary to underlying conditions, therapeutic toxicity, or extrahepatic disease complications.
- Rheumatologists must be aware of potential liver injury in patients with rheumatic diseases.
Purpose of the Study:
- To review the role of the liver in the clinical management of systemic rheumatic diseases.
- To highlight the importance of monitoring liver injury in rheumatology patients.
- To inform clinical rheumatologists about diagnostic procedures for liver abnormalities.
Main Methods:
- Review of existing data and literature concerning liver involvement in systemic rheumatic diseases.
- Analysis of associations between rheumatologic conditions and liver abnormalities.
- Examination of the impact of medical treatments and immunosuppressive agents on liver health.
Main Results:
- Systemic rheumatologic diseases can cause liver abnormalities through coexisting autoimmune liver diseases (e.g., primary biliary cirrhosis, autoimmune hepatitis).
- Direct liver parenchyma involvement and adverse effects of treatments (e.g., methotrexate) are significant factors.
- Immunosuppressive agents may reactivate or exacerbate underlying viral infections, particularly viral hepatitis.
Conclusions:
- Clinical rheumatologists need a thorough understanding of liver disease diagnostics and management in their patients.
- Monitoring for liver injury is crucial, considering autoimmune associations, direct involvement, and treatment-related toxicity.
- Awareness of viral hepatitis reactivation under immunosuppression is essential for comprehensive patient care.
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