Clinical Characteristics of Systemic Lupus Erythematosus with Cirrhosis

Abstract

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.

A radiomics-based model on non-contrast CT for predicting cirrhosis: make the most of image data

“…The AST to ALT ratio is frequently calculated for predicting fibrosis stage or clinical outcomes in chronic hepatitis [29,30]. It was reported that globulin is positively associate with mortality in patients with cirrhosis [31]. Serum gamma-globulin ≥18 g/L is a significant predictor of disease progression, tumor development and death for cirrhotic patients [32].…”

Clinical analysis of patients with systemic lupus erythematosus complicated with liver failure

“…other liver diseases, such as fat infiltration and overlapping autoimmune liver disease, virus infection, and alcoholism [6][7][8][9][10][11]. End-stage liver disease complicated with portal hypertension, cirrhosis, and hepatic encephalopathy is a rare complication of SLE unless there are nonalcoholic fatty liver disease (NAFLD), viral hepatitis, or autoimmune hepatitis (AIH) that existed simultaneously [3,6].…”

“…other liver diseases, such as fat infiltration and overlapping autoimmune liver disease, virus infection, and alcoholism [6][7][8][9][10][11]. End-stage liver disease complicated with portal hypertension, cirrhosis, and hepatic encephalopathy is a rare complication of SLE unless there are nonalcoholic fatty liver disease (NAFLD), viral hepatitis, or autoimmune hepatitis (AIH) that existed simultaneously [3,6]. It has been revealed that a few patients with end-stage liver disease, accompanied with portal hypertension and cirrhosis, did not die of liver failure, while the main cause of death was infection or cancer [4].…”

Chronic Liver Disease: A Mimic of Systemic Lupus Erythematosus

“…Chronic liver disease can also have overlapping features of systemic lupus erythematosus (SLE), such as arthralgia, cytopenia, and coagulation abnormalities, when seen with positive serologies and low complements, and can be confused for active SLE. Hypocomplementemia can be seen due to the low production of complement proteins [3]. Systemic lupus erythematosus (SLE) is an autoimmune disorder that can affect multiple organ systems including the kidneys, lungs, joints, bone marrow, and skin.…”

“…Chronic liver disease can also have overlapping features of systemic lupus erythematosus (SLE), such as arthralgia, cytopenia, and coagulation abnormalities, when seen with positive serologies and low complements, and can be confused for active SLE. Hypocomplementemia can be seen due to the low production of complement proteins [ 3 ].…”