[Liver involvement in systemic lupus erythematosus]

From the revision of the literature it emerges that liver disease in systemic lupus erythematosus (SLE) has been reported in 8 to 23% of the patients and usually is of modest clinical relevance. The incidence of liver abnormalities in 86 patients affected by SLE (9 men and 77 women, mean age 42.1 +/- 13.1 years) was therefore analysed. In our study, liver involvement was defined when at least two abnormal liver function tests in two different occasions were detected. Evidence of liver disease was found in 20 of our patients (23.2%); in 6 cases liver abnormalities were not directly caused by SLE: in 3 subjects the abnormalities found were induced by drugs, in 2 patients by infection and in the last one by fatty liver. In the remaining 14 cases (16.2%), whose hepatic involvement was really due to SLE, a higher frequency of positivity for anti-ds-DNA antibodies than in the other patients was observed (92.8% and 51.3% respectively in the two groups, p < 0.05). As not reported previously, these data suggest that liver disease is a prerogative feature of severe SLE. From our casistic in only 1 case the hepatic injury was the onset clinical manifestation of the disease and was clinically relevant as it was diagnosed as chronic active hepatitis. These observations therefore offer the opportunity to discuss the relationship between SLE and autoimmune hepatitis.