Autoimmune liver diseases in systemic rheumatic diseases

doi:10.3748/wjg.v28.i23.2527

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Jun 21, 2022 (publication date) through May 3, 2024

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jun 21, 2022; 28(23): 2527-2545
Published online Jun 21, 2022. doi: 10.3748/wjg.v28.i23.2527

Table 4 Clinical, laboratory, therapeutic and outcome data in 3 patients with systemic lupus erythematosus-autoimmune hepatitis overlap disease¹

Patient number	1	2	3
Sex	Female	Female	Female
SLE Dx age	19	50	20
ACR criteria	8/11	7/11	8/11
AIH Dx age	26	37	22
IAIHG score	Definite	Definite	Definite
Clinical
SLE	Skin, joint, renal, hematology, neurology	Skin, joint, renal, hematology, serositis	Skin, joint, renal, hematology, serositis
AILD complication	Jaundice, malaise LC with PH	Jaundice, pruritus hepatosplenomegaly	Jaundice, anorexia
Coexistent AID	Nil	PBC, SS	Nil
Laboratory
Hemogram	HA, TP	HA, TP, leukopenia	TP, leukopenia
Proteinuria autoantibody	2 g/d	2.5 g/d	1 g/d
SLE-related	ANA, anti-dsDNA/Sm	ANA, anti-dsDNA/Sm	ANA, anti-dsDNA
AILD-related	ASMA	AMA, ASMA	ASMA
Others	ARPA, ANCA	ARPA, anti-Ro/La	ARPA
²IgG (mg/dL)	2130	2520	1615
²AST (IU/L)	1563	116	97
²ALT (IU/L)	1093	217	177
²Bil (mg/dL)	23.8	3.7	2.4
²ALP (IU/L)	432	621	344
HLA-DR	DR8, DR15	DR4, DR15	DR4, DR7
VH	No ³HHV/CMV/EBV	No HHV/CMV/EBV	No HHV/CMV/EBV
Treatment	CS/AZA, LDLT and low-dose CS/FK506 after OP	CS/AZA, UDCA RTX and low-dose CS for maintenance	CS/AZA, AZA for maintenance
Outcome	Stabilized LFT and low SLEDAI	Normalized LFT and low SLEDAI	Normalized LFT and low SLEDAI

¹Enrollment from 2018 July to 2021 June.

²Peak levels during autoimmune hepatitis.

³Human hepatitis viruses including hepatitis A virus, hepatitis B virus and hepatitis C virus.

AID: Autoimmune disease; AIH: Autoimmune hepatitis; ALP: Alkaline phosphatase ALT: Alanine aminotransferase; AMA: Antimitochondrial autoantibody; ANCA: Antineutrophil cytoplasmic antibody; ARPA: Anti-ribosomal-P antibody; ASMA: Anti-smooth muscle antibody; AST: Aspartate aminotransferase; AZA: Azathioprine; Bil: Bilirubin; CMV: Cytomegalovirus; CS: Corticosteroids; Dx: Diagnosis; EBV: Epstein-Barr virus; IAIHG: International Autoimmune Hepatitis Group; HA: Hemolytic anemia; HHV: Human hepatitis viruses; LC: Liver cirrhosis; LDLT: Living donor liver transplantation; LFT: Liver function test; OP: Operation; PBC: Primary biliary cholangitis; PH: Portal hypertension; RTX: Rituximab; SLEDAI: SLE disease activity index; SS: Sjögren syndrome; TP: Thrombocytopenia; UDCA: Ursodeoxycholic acid; VH: Viral hepatitis.

Citation: Wang CR, Tsai HW. Autoimmune liver diseases in systemic rheumatic diseases. World J Gastroenterol 2022; 28(23): 2527-2545
URL: https://www.wjgnet.com/1007-9327/full/v28/i23/2527.htm
DOI: https://dx.doi.org/10.3748/wjg.v28.i23.2527