Lupus: Open Access
Open Access

Functional Abnormalities of Liver due to Lupus

Maria Mery Grizel^{* *}Correspondence: Maria Mery Grizel, Department of Allergy and Rheumatology, The University of Tokyo Hospital, Tokyo, Japan, Email:

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Description

Persons with Systemic Lupus Erythematosus (SLE) have the highest risk of acquiring abnormal liver tests during the course of their lives. Abnormal liver enzymes are a common symptom of systemic lupus erythematosus liver involvement [1]. Drug toxicity, comorbidities such fatty liver, and chronic Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) infections are all common causes of liver function abnormalities in lupus patients. The liver's involvement in lupus might owe to overlap with other autoimmune disorders including autoimmune hepatitis and primary biliary cirrhosis, or it can be attributable to the disease itself (lupus hepatitis). Lupus hepatitis has a non-specific liver histology [2].

SLE is typically associated with cutaneous, renal, musculoskeletal, and hematologic involvements; however hepatitis is not one of them. While clinically significant hepatopathy in SLE is uncommon, asymptomatic hypertransaminasemia has been reported in up to maximum of SLE patients at some point during their illness, and is usually attributed to viral hepatitis, hepatotoxic medications, or alcohol consumption [3]. A diagnosis of lupus hepatitis is typically regarded as an excluding diagnostic.

What effect does lupus have on the liver?

Liver aids in digestion and filters waste from blood. Lupus can harm the liver in a variety of ways.

Hepatitis: Hepatitis, or liver inflammation, can be caused by lupus and several lupus medications. Many persons with hepatitis don't have any symptoms, however some do: Nausea and vomiting, Jaundice (yellow skin or eyes), Fatigue (feeling fatigued), abdominal discomfort, Pale or grey stool, dark urine [4].

Lupus-related hepatitis is known as autoimmune hepatitis. This indicates that immune system has launched an attack on liver. Autoimmune hepatitis is divided into two types:

• Type 1 diabetes is the most common, affecting people of all ages.

• Type 2 is less prevalent, affecting girls between the ages of 2 and 14.

If a person has autoimmune hepatitis, doctor may prescribe steroids (such as prednisone) or azathioprine, a drug that helps immune system manages [2]. Doctor can do tests to determine the cause of hepatitis and the best treatment options.

Hepatic vasculitic: Inflammation of the blood arteries that bring blood to the liver is another symptom of lupus. This can result in blood clots and other complications [5].

Drug-induced hepatitis is the most common cause, although moderate, mostly lobular-but occasionally also portal and periportal-hepatitis reflecting SLE activity is another potential. Other liver illness in SLE, such as Budd-Chiari syndrome and veno-occlusive disease, can be linked to thrombotic events, whether or not they are caused by the lupus anticoagulant [3].

Conclusion

SLE is an autoimmune disease that causes a malar rash, arthralgias, cytopenias, serositis, renal failure, endocarditis, and antiphospholipid syndrome, among other symptoms. An increase in Liver Function Tests (LFTs) is one probable symptom of SLE. Although cases of lupus hepatitis that are resistant to corticosteroids and conventional immunosuppressants have been reported, prednisone therapy is effective. Treatment with mycophenolate mofetil has been demonstrated to be successful in these circumstances. Anti-ribosomal P autoantibodies are more common in lupus hepatitis than other lupus-specific autoantibodies. The anti-smooth muscle antigen is another autoantibody that has been linked to lupus hepatitis. Antimitochondrial antibodies, which are a particular marker for primary biliary cirrhosis, are identified in a small percentage of lupus patients.

References

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