Rheumatologic Diseases and the Liver

Gebreselassie, Agazi; Aduli, Farshad; Howell, Charles D.

doi:10.1016/j.cld.2018.12.007

Cited by 27 publications

(23 citation statements)

References 88 publications

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“…However, it is also a target of autoimmune reactions, as observed in primary autoimmune liver diseases (AILD) such as AIH, PBC, and primary sclerosing cholangitis (PSC). Further, the liver is frequently affected by connective tissue diseases (CTD), including systemic lupus erythematosus, antiphospholipid syndrome, primary Sjogren's syndrome, systemic sclerosis, vasculitis, dermatomyositis, polymyositis, and antisynthetase syndrome, most commonly in the form of abnormal liver function test with predominant cholestatic or hepatocellular damage [2,3,[7][8][9][10]. Although liver cirrhosis and failure are extremely rare in patients with SLE, unusual liver conditions such as nodular regenerative hyperplasia or Budd-Chiari syndrome have been reported with increasing frequency in patients with CTD [8].…”

Section: Discussionmentioning

confidence: 99%

“…The following data were obtained from medical records by well-trained rheumatologists: gender, age at entry, duration of SLE, involved organs, lupus disease activity, and laboratory data. Lupus disease activity was evaluated using the SLE disease activity index 2000 (SLE-DAI-2K), stratified to stable (<5), mild active (5)(6)(7)(8)(9), moderate active (10)(11)(12)(13)(14), and severe active (>14). The severity of liver diseases was evaluated with the Child-Pugh score.…”

Section: Clinical and Laboratory Datamentioning

confidence: 99%

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Clinical Characteristics of Systemic Lupus Erythematosus with Cirrhosis

You

Fei

Wang

et al. 2020

Journal of Immunology Research

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Aim. Cirrhosis is rare in systemic lupus erythematosus (SLE) patients with a poor prognosis. This study is aimed at retrospectively analyzing our single-center experience to explore the characteristics of cirrhosis in SLE patients. Methods. SLE patients with cirrhosis from 2012 to 2019 were enrolled. SLE diagnosis was rigorously confirmed by a medical record review according to the revised 1997 American College of Rheumatology classification criteria for SLE. The diagnosis of liver cirrhosis was based on a combination of clinical, laboratory, and imaging criteria features. We conducted a case-control study in SLE patients complicated with the cirrhosis group and the age-, sex-, and entry-time-matched noncirrhosis group. Results. A total of 21 patients with SLE cirrhosis were enrolled, 3 males and 18 females. The median age at the time of cirrhosis diagnosis was 47.3±4.0 years, and the mean disease duration of SLE before cirrhosis was 4.7±1.0 years. The most common initial presentation was the involvement of the hematological system in 9 patients and then skin and mucosal involvement in 5 patients, arthritis in 4 patients, and nephritis in 3 patients. Patients with cirrhosis had a significantly higher rate of hematological system involvement (thrombocytopenia and leukopenia) and worse liver function; a higher level of immune globulin G had higher mortality (p<0.05) than patients without cirrhosis. Conclusions. Cirrhosis is a rare and severe subtype of SLE with a poor prognosis. Those patients with hematological system involvement and impaired liver function should be paid more attention.

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Section: Discussionmentioning

confidence: 99%

Section: Clinical and Laboratory Datamentioning

confidence: 99%

Clinical Characteristics of Systemic Lupus Erythematosus with Cirrhosis

You

Fei

Wang

et al. 2020

Journal of Immunology Research

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“…The AIH patients are known to develop other concurrent autoimmune diseases due to significant epidemiologic, genetic, and immunologic overlap between immune-mediated rheumatologic diseases, and autoimmune liver diseases. [ 20 ] Most rheumatologic diseases manifest with elevated liver enzymes, but without significant parenchymal diseases. [ 20 ] Autoimmune thyroid disease and Sjogren syndrome are the most common extrahepatic autoimmune diseases among patients with autoimmune liver diseases.…”

Section: Discussionmentioning

confidence: 99%

“…[ 20 ] Most rheumatologic diseases manifest with elevated liver enzymes, but without significant parenchymal diseases. [ 20 ] Autoimmune thyroid disease and Sjogren syndrome are the most common extrahepatic autoimmune diseases among patients with autoimmune liver diseases. [ 21 ] It is critical to differentiate between rheumatologic disease-induced hepatitis and AIH due to therapeutic and prognostic implications; for instance, systemic lupus erythematous (SLE)-induced hepatitis and AIH both manifest as polyarthralgia, elevated gamma globulins and a positive antinuclear antibody, but further laboratory evaluation with serum antibodies, complement levels and liver histology can help differentiate between the 2 conditions.…”

Section: Discussionmentioning

confidence: 99%

The impact of bariatric surgery on in-patient clinical outcomes among patients with autoimmune hepatitis

et al. 2020

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Autoimmune hepatitis (AIH) is a form of liver inflammation in which immune cells target hepatocytes, inducing chronic inflammatory states. Bariatric surgery (BS) was shown to reduce inflammation in severely obese patients. We hypothesize that obese patients with AIH and BS have lower prevalence of liver-related complications and in-patient mortality compared to those without BS. The National Inpatient Sample from 2007 to 2013 was queried for hospitalizations of adults over 18 years of age with a diagnosis of AIH. Of those, hospitalizations with BS were selected as cases and those with morbid obesity as controls. Case-control 1:2 matching was done based on sex, age, race, and comorbidities. Primary outcomes were prevalence of liver-related complications and in-patient mortality. Independent risk factors of in-patient clinical outcomes were identified using multivariate regression analysis. From 137,834 hospitalizations with a diagnosis of AIH, 688 with BS were selected as cases, and 1295 were matched as controls. The prevalence of ascites was higher in the BS group compared to the control (odds ratio 1.73, 95% confidence interval (CI) 1.27–2.36). The prevalence of cirrhosis (36.8% vs 33.2%), portal hypertension (7.4% vs 10.0%), hepatic encephalopathy (10.6% vs 8.7%), and varices and variceal bleeding (3.9% vs 5.5%) was not statistically different from case controls, ( P > .05). BS was an independent risk factor for ascites (adjusted odds ratio (aOR) 1.87; 95% CI 1.36–2.56) and hepatic encephalopathy (aOR 1.42; 95% CI 1.03–1.97) but was an independent protective factor against in-patient mortality (aOR 0.21, 95% CI 0.08–0.55) once adjusted for age, sex, race, and comorbidities.

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“…The liver has a major role in the control of glucose homeostasis by controlling various glucose metabolism pathways, including glycogenesis, glycogenolysis, glycolysis and gluconeogenesis ( 19 ). Many primary immune-mediated liver disorders such as primary biliary cholangitis, autoimmune hepatitis and primary sclerosing cholangitis have rheumatologic manifestations ( 20 ). Liver damage is observed in many RA patients ( 21 , 22 ).…”

Section: Introductionmentioning

confidence: 99%

2-Deoxy-D-glucose Alleviates Collagen-Induced Arthritis of Rats and Is Accompanied by Metabolic Regulation of the Spleen and Liver

et al. 2021

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Rheumatoid arthritis (RA) is significantly associated with glycolysis. This study used 2-deoxy-D-glucose (2-DG), an inhibitor of glycolysis, to treat rats with collagen-induced arthritis (CIA) and investigate the metabolic regulatory mechanism of glycolysis in the disease. 2-DG significantly alleviated CIA. Metabolomics and transcriptomics, as well as their integrative analysis, detected significant changes in the pathways of bile secretion, cholesterol and linoleic acid metabolism in the plasma, liver and spleen during the CIA process and the opposite changes following 2-DG treatment, whereas the expression of the genes regulating these metabolic pathways were changed only in the spleen. In the rat liver, levels of (S)-5-diphosphomevalonic acid in the terpenoid backbone biosynthesis pathway were significantly decreased during CIA progression and increased following 2-DG treatment, and levels of taurochenodeoxycholic acid in the pentose and glucuronate interconversions pathway showed the opposite results. In the spleen, levels of 3-methoxy-4-hydroxyphenylglycol glucuronide in bile secretion and 12(S)-leukotriene B4 in arachidonic acid metabolism were significantly decreased during CIA progression and increased following 2-DG treatment. The changes in the gene-metabolite network of bile secretion in the spleen correlated with a decreased plasma L-acetylcarnitine level in CIA rats and an increase following 2-DG treatment. Our analysis suggests the involvement of spleen and liver metabolism in CIA under the control of glycolysis.

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Rheumatologic Diseases and the Liver

Cited by 27 publications

References 88 publications

Clinical Characteristics of Systemic Lupus Erythematosus with Cirrhosis

Clinical Characteristics of Systemic Lupus Erythematosus with Cirrhosis

The impact of bariatric surgery on in-patient clinical outcomes among patients with autoimmune hepatitis

2-Deoxy-D-glucose Alleviates Collagen-Induced Arthritis of Rats and Is Accompanied by Metabolic Regulation of the Spleen and Liver

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