Rheumatologic Diseases and the Liver

Clin Liver Dis. 2019 May;23(2):247-261. doi: 10.1016/j.cld.2018.12.007. Epub 2019 Mar 8.

Abstract

A variety of rheumatologic disorders may affect the liver. There is a significant epidemiologic, genetic, and immunologic overlap between immune-mediated rheumatologic disorders and autoimmune liver diseases. There is an increased frequency of autoimmune liver diseases, such as primary biliary cholangitis, autoimmune hepatitis, primary sclerosing cholangitis, or overlap syndrome, in patients with systemic lupus erythematosus, rheumatoid arthritis, Sjögren syndrome, systemic sclerosis, vasculitis, and other immune-related diseases. Non-immune-mediated rheumatologic diseases such as gouty arthritis may also have hepatic manifestations. Furthermore, medications used to treat rheumatologic diseases occasionally cause liver dysfunction. Conversely, primary immune-mediated and non-immune-mediated liver disorders may present with rheumatologic manifestations.

Keywords: Autoimmune liver disease; Elevated liver enzymes; Hepatotoxicity; Liver injury; Rheumatologic diseases.

Publication types

  • Review

MeSH terms

  • Acetaminophen / adverse effects
  • Anti-Inflammatory Agents, Non-Steroidal / adverse effects
  • Antirheumatic Agents / adverse effects*
  • Arthralgia / complications
  • Biological Products / adverse effects
  • Chemical and Drug Induced Liver Injury / etiology
  • Glucocorticoids / adverse effects
  • Humans
  • Liver Diseases / complications
  • Liver Diseases / etiology*
  • Rheumatic Diseases / complications*
  • Rheumatic Diseases / drug therapy*
  • Rheumatic Diseases / etiology

Substances

  • Anti-Inflammatory Agents, Non-Steroidal
  • Antirheumatic Agents
  • Biological Products
  • Glucocorticoids
  • Acetaminophen