Prevalence and risk factors of liver biochemical abnormalities in patients with systemic lupus erythematosus

Abstract

The aim of this work was to study the prevalence and risk factors of liver biochemical abnormalities in patients with systemic lupus erythematosus (SLE) and to investigate the cause of these abnormalities. Patients and methodsA total of 200 SLE patients attending the Rheumatology and Rehabilitation Department, Cairo University, were subjected to full medical history, assessment of disease activity using SLE disease activity index, calculation of BMI, laboratory investigations including complete blood count (CBC), erythrocyte sedimentation rate, C3, C4, liver and kidney functions, lipid profile, antinuclear antibodies, and anti-dsDNA. Patients with alteration of liver functions had further laboratory tests including viral hepatitis markers, hepatitis C virus (HCV) antibodies, hepatitis B virus surface antigen and hepatitis A virus antibodies, PCR for patients who had HCV-positive tests, autoimmune hepatitis (AIH) profile (antimitochondrial antibodies, antismooth muscle antibodies, and anti-liver-kidney microsomal antibodies), antiphospholipid profile (anticardiolipin, lupus anticoagulant, and B 2 glycoproteins), creatine phoshokinase (CPK), and abdominal ultrasound. ResultsThe prevalence of liver biochemical abnormalities was 6.5% two patients (15.4%) had HCVpositive antibodies, two patients (15.4%) had probable AIH, five patients (38.5%) had fatty liver, four patients (30.8%) had drug-induced hepatotoxicity, and two patients (15.4%) had no cause other than SLE itself. Hypertension, diabetes mellitus, and hyperlipidemia were more frequent in patients with elevated liver enzymes. ConclusionThe prevalence of elevated liver enzymes among SLE patients attending the Rheumatology and Rehabilitation Department during the time of the study was 6.5%. The most common liver abnormality was found to be fatty liver, affecting 38.5% of the patients, followed by drug-induced hepatotoxicity (30.8%), and then HCV infection, AIH, and SLE (each 15.4%).