Hepatopathie bei systemischem Lupus erythematodes – Ergebnisse einer explorativen Beobachtungsstudie

Kübel, Dorothee; Tiller, Maximilian; Mühling, Tobias; Sohn, Maximilian; Vallbracht, Inka; Waschulzik, Birgit; Schepp, Wolfgang; Gundling, Felix

doi:10.1055/a-0645-7200

Z Gastroenterol

2018

DOI: 10.1055/a-0645-7200

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Hepatopathie bei systemischem Lupus erythematodes – Ergebnisse einer explorativen Beobachtungsstudie

Dorothee Kübel

Maximilian Tiller

Tobias Mühling

et al.

Abstract: Elevated liver parameters occur frequently in patients with SLE, especially in context with increased disease activity (on the basis of ECLAM-Score or intensified immunosuppressive therapy) and prolonged course of the disease. Liver enzymes should be obtained regularly in patients with SLE and, if necessary, further diagnostic steps should be initiated. Further prospective studies might clarify whether abnormal liver parameters must be included in activity indices to judge disease activity in SLE.

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“…Outcomes for systemic lupus erythematosus (SLE) patients compared to non-SLE patients after coronary artery bypass grafting (CABG) surgery. in 123 patients, or 59.7% of patients overall[49]. While this number is considerable, Takahashi points out that of the patients with liver dysfunction, it was more likely that the dysfunction was drug-induced (30.9%) than a manifestation of SLE (28.5%).…”

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confidence: 99%

Hepatic and Renal Outcomes in Systemic Lupus Erythematosus Patients following Coronary Artery Bypass Grafting: A Study from the National Inpatient Sample

Bellam,

Sabe,

Huang

et al. 2023

Journal of Cardiac Surgery

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Background and Aim of the Study. While several studies have suggested a relationship between adverse postoperative outcomes and systemic lupus erythematosus (SLE) in major surgical settings, no study to date has explored postoperative outcomes of SLE patients undergoing coronary artery bypass grafting (CABG). This study aimed to compare the characteristics and outcomes of SLE patients compared to non-SLE patients undergoing CABG. Methods. We utilized the Nationwide Inpatient Sample (NIS) data from 2008–2018 for CABG patients ≥18 years old. Patients were divided into two groups based on SLE status (confirmed SLE diagnosis or no SLE present). Primary outcomes were in-hospital mortality, favorable discharge, and length of stay (LOS). Secondary outcomes included acute kidney injury (AKI), acute liver injury (ALI), hemodialysis, acute myocardial infarction (AMI), and cardiogenic shock. Patient characteristics including age, sex, race, and preexisting comorbidities were considered. Multivariable models, adjusting for confounding variables, were utilized. Results. Data from a total of 352,772 patients who underwent CABG were analyzed. 980 patients had a diagnosis code for SLE. SLE and non-SLE patients had similar rates of in-hospital mortality (OR = 0.92, [0.63–1.35]), nonhome discharge (OR = 1.09, [0.95–1.24]), and LOS (OR = 1.02, [0.99–1.06]). SLE patients developed AKI at a higher rate (OR = 1.50, [1.05–1.48]) and ALI at a lower rate (OR = 0.35, [0.16–0.74]). Both groups had similar rates of hemodialysis (OR = 1.19, [0.98–1.44]), AMI (OR = 0.93, [0.81–1.06]), and cardiogenic shock (OR = 0.8, [0.61–1.05]). Conclusion. These findings suggest that SLE patients undergoing CABG have similar mortality, discharge disposition, and LOS compared to non-SLE patients. However, SLE patients are at increased risk of AKI and decreased risk of ALI than non-SLE patients. These associations warrant further investigation to elucidate their physiologic basis.

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mentioning

confidence: 99%

Hepatic and Renal Outcomes in Systemic Lupus Erythematosus Patients following Coronary Artery Bypass Grafting: A Study from the National Inpatient Sample

Bellam,

Sabe,

Huang

et al. 2023

Journal of Cardiac Surgery

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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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Fibroscan detection of fatty liver and liver fibrosis in patients with systemic lupus erythematosus

Yetginoglu

Ataş

Yılmaz

et al. 2022

Lupus

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Objective Although liver dysfunction is not considered the main organ involvement in Systemic Lupus Erythematosus (SLE), the frequency of liver dysfunction or abnormal liver enzyme values may be observed in 50–60% of patients. The aim of this study was to assess fatty liver and liver fibrosis in SLE patients using Fibroscan as well as determine associated factors such as immunosuppressive medications. Methods Sixty SLE patients and 30 healthy controls were included. Patients with HBV, HCV or cirrhosis, malignancy, cardiac disease, or patients on dialysis were excluded. All participants underwent Fibroscan measurements. Results The prevalence of fatty liver disease was similar between SLE patients and healthy controls (21.7 vs 26.7%, p = .597). Liver fibrosis was also similar between the two groups (26.7 vs 10.0%, p = .069). Since the majority of SLE patients were female, we performed a subgroup analysis in female patients ( n = 51) and controls ( n = 25). Fatty liver disease was similar between female SLE patients and controls (23.5 vs 24.0%, p = .964). However, liver fibrosis in female patients with SLE was increased compared to female controls (29.4 vs 4.0%, p = .011) and was associated with age (Exp (B) 95% CI: 1.083 (1.006–1.166), p = .034) and low-dose cumulative glucocorticoid use (Exp (B) 95% CI: 14.116 (1.213–164.210), p = .034). Conclusion The prevalence of fatty liver was similar between SLE patients and controls, while liver fibrosis was increased in the female patient group as compared to controls. Furthermore, liver fibrosis was associated with age and low dose cumulative glucocorticoid use. Interestingly, fatty liver did not precede liver fibrosis in the majority of cases, contrary to what is observed in the general population. Larger studies are needed to confirm our findings and determine whether immunosuppressive use has any impact on the development of liver fibrosis in SLE patients.

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Hepatopathie bei systemischem Lupus erythematodes – Ergebnisse einer explorativen Beobachtungsstudie

Cited by 3 publications

References 17 publications

Hepatic and Renal Outcomes in Systemic Lupus Erythematosus Patients following Coronary Artery Bypass Grafting: A Study from the National Inpatient Sample

Hepatic and Renal Outcomes in Systemic Lupus Erythematosus Patients following Coronary Artery Bypass Grafting: A Study from the National Inpatient Sample

Hepatic manifestations in systemic lupus erythematosus

Fibroscan detection of fatty liver and liver fibrosis in patients with systemic lupus erythematosus

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