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Liver function in some common rheumatic disorders

A Akesson, K Berglund, M Karlsson

    Scandinavian Journal of Rheumatology
    |January 1, 1980
    PubMed
    Summary
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    Elevated liver enzymes, including gamma glutamyl transferase and alkaline phosphatase, are common in arthritis patients. These enzyme changes may represent an unspecific inflammatory response rather than drug-induced liver injury.

    Area of Science:

    • Hepatology
    • Rheumatology
    • Clinical Biochemistry

    Background:

    • Liver function abnormalities are frequently observed in patients with inflammatory conditions.
    • Understanding the causes of these abnormalities is crucial for patient management.

    Purpose of the Study:

    • To investigate the prevalence and patterns of liver dysfunction in patients with rheumatoid arthritis and other inflammatory arthropathies.
    • To differentiate between drug-induced hepatotoxicity and inflammatory responses.

    Main Methods:

    • Assessed liver function using serum gamma glutamyl transferase and alkaline phosphatase levels.
    • Further evaluated liver function with serum amino-transferases, alkaline phosphatase isoenzyme analysis, 99mtechnetium scintigraphy, and liver biopsy in subsets of patients.

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  • Correlated liver enzyme levels with disease activity indices (ESR, serum orosomucoid) and medication use.

    • Main Results:

    • Elevated gamma glutamyl transferase (47%) and alkaline phosphatase (24%) were common in rheumatoid arthritis patients.
    • Liver dysfunction was also observed in non-rheumatoid arthritis and polymyalgia rheumatica patients.
    • Liver biopsy indicated reactive hepatitis, and hepatotoxicity was not linked to specific drugs; chloroquine and corticosteroids showed potential enzyme-lowering effects.
    • Isolated enzyme elevations in arthritis patients may be an unspecific reaction to inflammation.

    Conclusions:

    • Elevated serum gamma glutamyl transferase and alkaline phosphatase are frequent in arthritis, often reflecting an unspecific inflammatory response.
    • Hepatotoxicity is not clearly attributable to specific medications in this cohort.
    • Further research may clarify the precise mechanisms and clinical significance of these liver enzyme alterations in inflammatory diseases.