Liver involvement in rheumatic diseases

Podgórska, Joanna; Werel, Paulina; Klapaczyński, Jakub; Orzechowska, Dorota; Wudarski, Mariusz; Gietka, Andrzej

doi:10.5114/reum.2020.99782

Cited by 10 publications

(11 citation statements)

References 56 publications

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“…For our patients, it is unclear whether NRH developed secondary to JDM, hepatotoxic medications, or a combination of both. NRH has been associated with systemic autoimmune disorders, including inflammatory bowel disease, scleroderma, rheumatoid arthritis, systemic lupus erythematosus, polyarteritis nodosa, Behçet disease, and antiphospholipid syndrome [ 3 , 6 , 7 ]. An analysis of 160 patients with connective tissue disease revealed seven NRH cases in patients with lupus, systemic sclerosis, and polyarteritis nodosa.…”

Section: Discussionmentioning

confidence: 99%

Nodular Regenerative Hyperplasia of the liver in Juvenile Dermatomyositis

et al. 2022

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Background We present two cases of Nodular Regenerative Hyperplasia (NRH) associated with Juvenile Dermatomyositis (JDM). Case Presentation Case 1: A nine-year-old Caucasian male with refractory JDM and anti-NXP2 autoantibodies was diagnosed at age two. Over seven years, he developed arthritis, dysphagia, dysphonia, severe calcinosis, and colitis. Complications included recurrent cellulitis, infections, and hepatosplenomegaly. Multiple medications were chronically used, including prednisone, methotrexate, azathioprine, cyclophosphamide, mycophenolate mofetil, rituximab, tacrolimus, etanercept, abatacept, infliximab, and tocilizumab. Case 2: A 19-year-old Asian female with chronically active JDM and anti-MDA5 autoantibodies was diagnosed at age 15. Symptomatology included ulcerative skin lesions, Raynaud’s phenomenon with digital ulcers, arthritis, interstitial lung disease with pulmonary hypertension, and calcinosis. Medications included chronic use of prednisone, methotrexate, abatacept, cyclophosphamide, mycophenolate mofetil, rituximab, tofacitinib, and sildenafil. In both patients, clinical symptomatology was not suggestive of liver disease or portal hypertension, but laboratory studies revealed elevated serum transaminases with progressive thrombocytopenia and no active liver-associated infections. The first patient’s liver ultrasound showed coarse hepatic texture with mild echogenicity, splenomegaly, and portal hypertension. The second patient’s liver ultrasound was normal, but elastography indicated increased stiffness. Liver biopsy confirmed NRH in both patients. Conclusions It is difficult to recognize NRH in JDM, as it often presents with elevated transaminases which may be mistaken for JDM muscle flare, corticosteroid-related fatty liver, or medication-related transaminitis. NRH has been associated with several medications used to treat JDM, including methotrexate, azathioprine, and cyclophosphamide, which should be discontinued if NRH develops. Providers should consider NRH in JDM patients with severe, refractory disease who have persistently elevated transaminases and persistent thrombocytopenia.

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Section: Discussionmentioning

confidence: 99%

Nodular Regenerative Hyperplasia of the liver in Juvenile Dermatomyositis

et al. 2022

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“…Of note, SpA (axial or peripheral) is more commonly observed in Crohn's disease than in ulcerative colitis. The common pathogenetic mechanisms that explain the link between IBD and SpA are still ill-defined [19,20].…”

Section: Spondyloarthropathies (Spa)mentioning

confidence: 99%

“…The autoimmune connective tissue diseases have a complex pathogenesis with a multifactorial etiology. In the course of these diseases develop an autoimmune response leading to chronic inflammation and that sometimes may cause multiorgan dysfunction.The liver is a life-sustaining organ which is responsible for detoxification of drugs and other harmful substances, metabolism of hormones, storage and release of proteins, cholesterol and vitamins and also an active organ of immune response [19].…”

Section: Hepatic Manifestations Of Pediatric Rheumatic Diseasesmentioning

confidence: 99%

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Gastro-Intestinal Manifestations of Pediatric Rheumatic Diseases

Soliman

Hassan

Elsayed

2021

Benha Journal of Applied Sciences

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“…Internal and Geriatric Medicine Department, Azienda Sanitaria Locale Napoli 3 sud, Rheumatologic Outpatient Clinic Hospital "Mariano Lauro", Sant'Agnello, Naples, Italy Dear Editor, We read with great interest the review paper entitled "Liver involvement in rheumatic diseases" [1]. In this letter, our aim is to add a brief focus about the hepatic manifestations related to polymyalgia rheumatica (PMR) and giant cell arteritis (GCA) according to the evidences of literature.…”

mentioning

confidence: 99%

Liver involvement in polymyalgia rheumatica and giant cell arteritis

Hysa¹,

Castagna²,

Manzo

2020

Reumatologia

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This is a Letter to the Editor and no abstract is required. The Editorial System did not allow a proper insertion. This is a Letter to the Editor and no abstract is required. The Editorial System did not allow a proper insertion. This is a Letter to the Editor and no abstract is required. The Editorial System did not allow a proper insertion. This is a Letter to the Editor and no abstract is required. The Editorial System did not allow a proper insertion. This is a Letter to the Editor and no abstract is required.

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Liver involvement in rheumatic diseases

Cited by 10 publications

References 56 publications

Nodular Regenerative Hyperplasia of the liver in Juvenile Dermatomyositis

Nodular Regenerative Hyperplasia of the liver in Juvenile Dermatomyositis

Gastro-Intestinal Manifestations of Pediatric Rheumatic Diseases

Liver involvement in polymyalgia rheumatica and giant cell arteritis

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