Egyptian Rheumatology and Rehabilitation (Jan 2014)

Prevalence and risk factors of liver biochemical abnormalities in patients with systemic lupus erythematosus

  • Reem Ismail El Shazly,
  • Wafaa Hob Sharkawy Mohammed,
  • Sahar Fakhreldin Mohamed,
  • Mohamed Ibrahim Saif Elnasr

DOI
https://doi.org/10.4103/1110-161X.147352
Journal volume & issue
Vol. 41, no. 4
pp. 139 – 147

Abstract

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Aim of the work The aim of this work was to study the prevalence and risk factors of liver biochemical abnormalities in patients with systemic lupus erythematosus (SLE) and to investigate the cause of these abnormalities. Patients and methods A total of 200 SLE patients attending the Rheumatology and Rehabilitation Department, Cairo University, were subjected to full medical history, assessment of disease activity using SLE disease activity index, calculation of BMI, laboratory investigations including complete blood count (CBC), erythrocyte sedimentation rate, C3, C4, liver and kidney functions, lipid profile, antinuclear antibodies, and anti-dsDNA. Patients with alteration of liver functions had further laboratory tests including viral hepatitis markers, hepatitis C virus (HCV) antibodies, hepatitis B virus surface antigen and hepatitis A virus antibodies, PCR for patients who had HCV-positive tests, autoimmune hepatitis (AIH) profile (antimitochondrial antibodies, antismooth muscle antibodies, and anti-liver-kidney microsomal antibodies), antiphospholipid profile (anticardiolipin, lupus anticoagulant, and B 2 glycoproteins), creatine phoshokinase (CPK), and abdominal ultrasound. Results The prevalence of liver biochemical abnormalities was 6.5% two patients (15.4%) had HCV-positive antibodies, two patients (15.4%) had probable AIH, five patients (38.5%) had fatty liver, four patients (30.8%) had drug-induced hepatotoxicity, and two patients (15.4%) had no cause other than SLE itself. Hypertension, diabetes mellitus, and hyperlipidemia were more frequent in patients with elevated liver enzymes. Conclusion The prevalence of elevated liver enzymes among SLE patients attending the Rheumatology and Rehabilitation Department during the time of the study was 6.5%. The most common liver abnormality was found to be fatty liver, affecting 38.5% of the patients, followed by drug-induced hepatotoxicity (30.8%), and then HCV infection, AIH, and SLE (each 15.4%).

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