Rheumatoid liver?

Raised serum alkaline phosphatase in rheumatoid disease. An index of liver dysfunction?

“…The increase in rheumatoid patients has been attributed to osteoblastic activity (Frank and Klemmayer, 1968). However, we believe that an hepatic origin is more likely because a simultaneous rise in serum 5nucleotidase (5-NT) occurred in our patients with increased alkaline phosphatase (Kendall, Cockel, Becker, and Hawkins, 1970). Serum 5-NT is increased in liver disease though normal in bone disorders (Dixon and Purdom, 1954).…”

Clinical associations between arthritis and liver disease.

“…The concept of a 'rheumatoid liver' was based on the finding that 26 % of rheumatoid arthritis patients had raised serum alkaline phosphatase levels, which were confirmed to be of hepatic origin by correlation with elevated serum 5-nucleotidase concentrations. [56][57][58] These results have been confirmed with serum alkaline phosphatase levels being elevated in 18%, 35 %, and 51 % of 3 large series of rheumatoid arthritis patients,54 5960 the isoenzyme being of liver origin in the majority of cases. In 100 rheumatoid arthritis patients serum alkaline phosphatase was elevated in 47 % of patients with features of the sicca complex but in only 19 % of those with normal salivary and lacrimal gland function.59 Dynamic tests of hepatic function, in particular the bromsulphthalein (BSP) excretion test were abnormal in 5 6% of rheumatoid arthritis patients and 18 8 % of Sj6gren's syndrome patients.54 Serum bilirubin and the transaminases are, in contrast, almost invariably normal.'…”