Purpose of Review We aim to review 1) the changing epidemiology of liver disease and the impact that systematic differences in the opportunities for ethnic and racial minorities to gain access to care have had on mortality and 2) community interventions aimed at reducing disparities. Recent Findings There continues to be disparities in acute/chronic viral hepatitis. The success of the campaign to eliminate viral hepatitis depends on innovative initiatives like home-based screening in highest risk communities and improved access to treatment. We describe increasing rates of high-risk drinking and a need for culturally tailored treatment. We discuss rising rates of non-alcohol associated fatty liver disease and the need for improved education of patients and providers. Data on disparities in mortality in cholestatic liver diseases are emerging; qualitative data on barriers to care are needed. Summary Understanding racial disparities in liver disease is only the first step. Achieving health equity will take innovative initiatives. Publisher's NoteSpringer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
This paper discusses the presentation of a rare drug side effect, a case of drug-induced lupus presenting with weight loss, weakness, hepatitis, and pancreatitis. A 24-year-old male with a history of major depressive disorder and childhood seizures presented to the ER with symptoms of abdominal pain, significant weight loss, and weakness. Initial workup revealed acute pancreatitis, elevated liver function enzymes (LFTs), and abnormal anti-double-stranded DNA antibody (anti-dsDNA) 1 : 640. He showed no classical clinical signs of lupus including rash, arthritis, or photosensitivity. He had multiple hospitalizations in the previous 6 months for excessive weight loss, malnutrition, weakness, and altered mental status. He had been taking lamotrigine for seizure prevention and mood stabilization while on a selective serotonin reuptake inhibitor (SSRI) and had a decline in health since the lamotrigine dose was increased. Antihistone antibodies were positive suggesting a drug-induced lupus syndrome. We hope to bring awareness to the possible rare complication of lamotrigine-induced lupus.
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