Subclinical liver disease in systemic lupus erythematosus

In a detailed retrospective analysis of 81 patients with systemic lupus erythematosus (SLE), elevated serum "liver enzymes" were recorded in 45 (55%) subjects. In 9 cases, the cause was non-hepatic and in 14 cases liver dysfunction was probably drug induced. Aspirin was the most common offender. Of the remaining 22 patients, 3 had congested livers secondary to heart failure and 19 had no obvious cause for liver dysfunction other than SLE itself. Liver histology was reviewed in 7 of these 19 patients. An inflammatory infiltrate of the portal areas was seen in 5, fatty liver in one and chronic active hepatitis in one. The frequency of liver dysfunction and the associated portal inflammation support the view that subclinical liver disease is a concomitant feature of SLE.