BACKGROUND Elevated serum uric acid (UA) level strongly reflects and may even cause oxidative stress, metabolic syndrome and insulin resistance which are risk factors for progression of liver disease. Hepatic injury is associated with distortion of the metabolic function. Hepatic disease/Cirrhosis of liver can be evaluated by biochemical analysis of serum tests, includes levels of serum alanine and aspartate amino transferases, alkaline phosphatase, and also by uric acid estimation. In chronic liver disease, high serum uric acid is associated with more severe disease. However, there are limited numbers of studies showing the association of uric acid with different parameters of liver dysfunction. METHODS In this study a total of 66 patients of known chronic liver disease of different causes were included. All patients were above 18 years of age. Patients with factors that influence the serum uric acid level were excluded. A thorough history was obtained, and physical examination was done. Various laboratory data including serum uric acid level and liver function test were measured. Using different parameters, Child Turcotte Pugh (CTP) score was calculated for each patient. Using suitable statistical method, data was analysed for any association between serum uric acid level and different causes of chronic liver disease and disease severity using Child Turcotte Pugh (CTP) grading. RESULTS In our study, out of 66 patients suffering from chronic liver disease, 48 (72.7%) were male. Alcohol was the most common cause (69.7%) of CLD followed by chronic hepatitis C (15.2%). A higher serum uric acid level was observed among patients with non-alcoholic fatty liver disease (NAFLD) (7.04±1.61) and patients with CTP class C (8.26±1.75). CONCLUSIONS From our study, we can conclude that uric acid is higher in patients with NAFLD as hyperuricemia is associated with many risk factors for NAFLD such as obesity, insulin resistance and metabolic syndrome. Serum uric acid is also higher with higher CTP score which is an oxidative marker for liver damage.

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Association of systemic lupus erythromatosus with hemophagocytic lymphohistiocytosis (HLH) has been reported by many authors 1,2,3,4 however association of systemic lupus erythromatosus with hemophagocytic lymphohistiocytosis and hypoplastic bone marrow is quite rare. Here we are reporting a case of HLH developing in a known case of SLE presenting with hypoplastic bone marrow in a 45 years old female, on low dose steroid therapy who presented with febrile pancytopenia, hepatosplenomegaly, hyperferritinemia with evidence of bone marrow hypoplasia and haemophagocytosis.