Multiple Hepatic Micro-Hypodensities as a Presenting Sign in Systemic Lupus Erythematosus- A Case Report

Mathapathi, Samarth; Preziosi, M

doi:10.2174/1874312902014010022

Cited by 1 publication

(14 citation statements)

References 14 publications

(11 reference statements)

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“…In retrospective studies, liver function abnormalities have been found in a significant proportion of SLE patients, and the diagnosis of liver disease often occurs after the diagnosis of SLE 1,2 . Hepatic vasculitis, although rare, has been reported in a small number of SLE cases 4,5,9 . However, there is conflicting data on the incidence of hepatic vasculitis in SLE due to variations among different studies 1–10 .…”

Section: Discussionmentioning

confidence: 99%

“…In this case, the absence of infectious features, the presence of autoimmune thrombocytopenia, and the patient's response to corticosteroid therapy supported the diagnosis of hepatic vasculitis. The management of hepatic vasculitis in SLE involves immunosuppressive therapy to control disease activity and prevent further vascular damage 4,5,9 . High‐dose corticosteroids are commonly used as the initial treatment, with the addition of other immunosuppressive agents if necessary 4,5,9 .…”

Section: Discussionmentioning

confidence: 99%

“…Several variables may cause liver problems in SLE, although the specific cause is uncertain. Drug‐induced liver dysfunction, alcohol intake, congestive heart failure, infections, and metabolic disorders are common secondary causes of SLE biochemical abnormalities 1–7 . Fatty liver, portal inflammation, cirrhosis, cholestasis, chronic active, chronic persistent, non‐specific reactive, granulomatous, nodular regenerative hyperplasia, hepatic infarction, and arteritis have also been reported 1–7 .…”

Section: Introductionmentioning

confidence: 99%

“…Drug-induced liver dysfunction, alcohol intake, congestive heart failure, infections, and metabolic disorders are common secondary causes of SLE biochemical abnormalities. [1][2][3][4][5][6][7] Fatty liver, portal inflammation, cirrhosis, cholestasis, chronic active, chronic persistent, non-specific reactive, granulomatous, nodular regenerative hyperplasia, hepatic infarction, and arteritis have also been reported. [1][2][3][4][5][6][7] Granulomatous hepatitis is rare in SLE, occurring in only a tiny percentage of histologically proven liver disorders.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] Fatty liver, portal inflammation, cirrhosis, cholestasis, chronic active, chronic persistent, non-specific reactive, granulomatous, nodular regenerative hyperplasia, hepatic infarction, and arteritis have also been reported. [1][2][3][4][5][6][7] Granulomatous hepatitis is rare in SLE, occurring in only a tiny percentage of histologically proven liver disorders. 8 Hepatic vasculitis, another rare SLE symptom, is inconsistently reported.…”

Section: Introductionmentioning

confidence: 99%

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Hepatic micro‐abscesses as an unusual initial presentation of systemic lupus erythematosus: A case report

Sasi,

Eltahir,

Ibrahim

et al. 2024

Clinical Case Reports

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Key Clinical MessageHepatic micro‐abscesses can be a rare initial presentation of systemic lupus erythematosus (SLE). This case highlights the importance of considering autoimmune etiologies when infectious causes are ruled out and emphasizes the need for early recognition and appropriate treatment of atypical hepatic manifestations in SLE to achieve favorable outcomes.AbstractSystemic lupus erythematosus (SLE) is an autoimmune disease that affects multiple organs, including the liver. While hepatic involvement in SLE is typically subclinical or associated with mild liver enzyme elevations, rare manifestations such as hepatic micro‐abscesses and hepatic vasculitis have been reported. We report the case of a 27‐year‐old female who presented with persistent high‐grade fever, bilateral exudative lymphocytic pleural effusion, hepatic micro‐abscesses, anemia, and lymphopenia. Despite extensive investigations and antibiotic therapy, the patient's condition continued to worsen. The diagnosis of hepatic vasculitis, a rare manifestation of SLE, was ultimately made based on clinical suspicion, positive autoimmune markers, and negative septic workup. The patient responded well to high‐dose corticosteroid therapy and intravenous immunoglobulin, with resolution of liver lesions and clinical improvement. Hepatic involvement in SLE is diverse, and atypical presentations can pose diagnostic challenges. Hepatic vasculitis, although rare, should be considered in SLE patients presenting with liver lesions. The management involves immunosuppressive therapy, and prompt diagnosis is crucial to prevent further vascular damage. Hepatic micro‐abscesses, another rare manifestation of SLE, are thought to result from immune complex deposition. The exact pathogenesis remains unclear. Hepatic micro‐abscesses can have both infectious and non‐infectious causes, and it is very important to rule out common microbial pathogens. Treatment focuses on managing the underlying SLE activity with immunosuppressive agents. This case highlights the diagnostic challenges and management considerations in atypical hepatic manifestations of SLE. Awareness of rare presentations and collaboration among multiple specialties are essential for accurate diagnosis and appropriate treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%