Liver transplantation in systemic lupus erythematosus: case report and review of the literature

Zazzetti, F.; Buschiazzo, Ambra; Villamil, F; Barreira, J.C.

doi:10.1177/0961203310377219

Cited by 6 publications

(5 citation statements)

References 18 publications

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“…There are few reports of liver transplants in patients with SLE. 85 These have few patients with diseases not related to SLE as indications for transplantation and generally obtaining favourable results with complications not related to SLE. In addition, immunosuppressive medications to prevent graft rejection are usually sufficient to suppress SLE activity.…”

Section: Treatment Of Liver Diseases In Slementioning

confidence: 99%

Hepatic manifestations in systemic lupus erythematosus

González-Regueiro

Cruz-Contreras

Merayo-Chalico

et al. 2020

Lupus

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Systemic lupus erythematosus (SLE) is a multi-organic autoimmune disease with a wide variety of clinical manifestations. However, hepatic dysfunction is not included in the diagnostic criteria for the disease and has not been recognized properly. The spectrum of hepatic involvement described in these patients ranges from abnormalities in liver function tests (LFTs) to fulminant hepatic failure. Usually, abnormalities in LFTs are only mild and transient, have a hepatocellular pattern and are not related to SLE but rather are mostly drug related. The most frequent finding on liver biopsy is steatosis (non-alcoholic fatty liver disease). Patients do not frequently progress to advanced chronic liver disease, and their outcome is favourable. Those who develop cirrhosis have traditional risk factors, such as other non-SLE-related conditions. In this work, we aim to review hepatic manifestations in patients with SLE, as well as the diagnostic and therapeutic approaches used for different liver diseases in these patients.

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Section: Treatment Of Liver Diseases In Slementioning

confidence: 99%

Hepatic manifestations in systemic lupus erythematosus

González-Regueiro

Cruz-Contreras

Merayo-Chalico

et al. 2020

Lupus

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“…Severe liver involvement requiring liver transplantation in SLE, but very few cases have been reported. The patient persisted without reactivation of SLE and with long-term survival (10) .…”

Section: Introductionmentioning

confidence: 82%

Liver Involvement in Systemic Lupus Erythematosus Patients

Shahin

Alazkalany

Hasaballah

et al. 2017

Suez Canal University Medical Journal

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Background: Systemic lupus erythematosus (SLE) is a potentially severe, frequently disabling autoimmune disease with multi-organ involvement. Liver involvement in SLE is not uncommon. It is frequently asymptomatic and limited to liver tests abnormalities. Aim: To detect the frequency and nature of liver involvement in SLE patients and to correlate these with other organ involvement. Patients and Methods: A retrospective study included 200 SLE patients who had admitted at Rheumatology and Rehabilitation department, Faculty of Medicine, Cairo university. Patients were classified into two groups Group I (no liver affection) and Group II (with liver affection). These groups were subdivided into subgroups; A (6 patients with AIH), B (194 patients without AIH), C (13 patients with fatty changes), D (187 patients without fatty changes), E (6 patients with HCV) & F (194 patients without HCV). Patients were subjected to full history taking, clinical examination and laboratory investigations; the erythrocyte sedimentation rate (ESR), complete blood count (CBC), serum creatinine, alanine transaminases (ALT), aspartate transaminases (AST), Autoantibodies (ANA and Anti DNA, and Anti LKM), serum complement levels (C3, C4), urine analysis, total albumin in 24 hours urine and HCV by PCR. Liver and renal biopsies were done in selected patients. Patients were also subjected to plain X-ray and abdominal sonography. Assessment of disease damage was measured by using systemic lupus erythematosus international collaborating clinic (SLICC). Results: Liver involvement was found in 23 SLE patients (11%). We classified the 23 patients into 5 major groups: Autoimmune hepatitis in 6 patients (26%), Cholangitis in 1 patient (4.3%), portal venous thrombosis in 2 patients (8.6%), Cirrhosis in 1 patient (4.3%), Liver congestion in 1 patient (4.3%), fatty changes in 13 patients (56.6%), HCV in 6 patients (26%). A significant relation between the age of onset, presence of ascites and SLICC in group A compared to B (p=0.034, p=0.007 and p=0.010 respectively) was found. Conclusion: Liver in SLE is the least organ affected. The younger the age group of lupus patients with AIH, the more the organ damage.

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“…Barthel et al first reported the use of liver transplantation in three patients with SLE; two did very well, and one experienced hyperacute rejection [ 28 ]. Lian EC et al and F Zazzetti et al each reported a patient with SLE; both patients underwent transplantation because of liver failure, did not have SLE reactivation and had good long-term survival [ 33 , 34 ]. These reports show that patients with SLE are capable of undergoing liver transplantation without experiencing SLE reactivation and have good long-term survival.…”

Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus combined with Wilson’s disease: a case report and literature review

Yang,

Li,

Liu

et al. 2024

BMC Pediatr

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Background Systemic lupus erythematosus (SLE) and Wilson’s disease (WD) are both systemic diseases that can affect multiple organs in the body. The coexistence of SLE and WD is rarely encountered in clinical practice, making it challenging to diagnose. Case report We present the case of a 9-year-old girl who initially presented with proteinuria, haematuria, pancytopenia, hypocomplementemia, and positivity for multiple autoantibodies. She was diagnosed with SLE, and her blood biochemistry showed elevated liver enzymes at the time of diagnosis. Despite effective control of her symptoms, her liver enzymes remained elevated during regular follow-up. Laboratory tests revealed decreased serum copper and ceruloplasmin levels, along with elevated urinary copper. Liver biopsy revealed chronic active hepatitis, moderate inflammation, moderate-severe fibrosis, and a trend towards local cirrhosis. Genetic sequencing revealed compound heterozygous mutations in the ATP7B gene, confirming the diagnosis of SLE with WD. The girl received treatment with a high-zinc/low-copper diet, but her liver function did not improve. Upon recommendation following multidisciplinary consultation, she underwent liver transplantation. Unfortunately, she passed away on the fourth day after the surgery. Conclusions SLE and WD are diseases that involve multiple systems and organs in the body, and SLE complicated with WD is rarely encountered in the clinic; therefore, it is easy to misdiagnose. Because penicillamine can induce lupus, it is not recommended. Liver transplantation is indicated for patients with liver disease who do not respond to medical treatment with WD. However, further research is needed to determine the optimal timing of liver transplantation for patients with SLE complicated with WD.

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Liver transplantation in systemic lupus erythematosus: case report and review of the literature

Cited by 6 publications

References 18 publications

Hepatic manifestations in systemic lupus erythematosus

Hepatic manifestations in systemic lupus erythematosus

Liver Involvement in Systemic Lupus Erythematosus Patients

Systemic lupus erythematosus combined with Wilson’s disease: a case report and literature review

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