Department of Internal Medicine, Nephrology and Ageing, University of Bologna, 40138 Bologna, Italy.
World J Gastroenterol. 2011 Oct 28;17(40):4503-8. doi: 10.3748/wjg.v17.i40.4503.
To investigate whether systemic lupus erythematosus (SLE) is associated with benign focal liver lesions and vascular liver diseases, since these have been occasionally reported in SLE patients.
Thirty-five consecutive adult patients with SLE and 35 age- and sex-matched healthy controls were evaluated. Hepatic and portal vein patency and presence of focal liver lesions were studied by colour-Doppler ultrasound, computerized tomography and magnetic resonance were used to refine the diagnosis, clinical data of SLE patients were reviewed.
Benign hepatic lesions were common in SLE patients (54% vs 14% controls, P < 0.0001), with hemangioma being the most commonly observed lesion in the two groups. SLE was associated with the presence of single hemangioma [odds ratios (OR) 5.05; 95% confidence interval (CI) 1.91-13.38] and multiple hemangiomas (OR 4.13; 95% CI 1.03-16.55). Multiple hemangiomas were associated with a longer duration of SLE (9.9 ± 6.5 vs 5.5 ± 6.4 years; P = 0.04). Imaging prior to SLE onset was available in 9 patients with SLE and hemangioma, showing absence of lesions in 7/9. The clinical data of our patients suggest that SLE possibly plays a role in the development of hemangioma. In addition, a Budd-Chiari syndrome associated with nodular regenerative hyperplasia (NRH), and a NRH associated with hepatic hemangioma were observed, both in patients hospitalized for abdominal symptoms, suggesting that vascular liver diseases should be specifically investigated in this population.
SLE is associated with 5-fold increased odds of liver hemangiomas, suggesting that these might be considered among the hepatic manifestations of SLE.
研究系统性红斑狼疮（SLE）是否与良性局灶性肝病变和血管性肝病相关，因为这些病变偶尔在 SLE 患者中被报道。
评估了 35 例连续的成年 SLE 患者和 35 名年龄和性别匹配的健康对照者。通过彩色多普勒超声评估肝和门静脉通畅性以及局灶性肝病变的存在，计算机断层扫描和磁共振成像用于细化诊断，回顾 SLE 患者的临床资料。
SLE 患者中良性肝病变很常见（54%比对照组的 14%，P < 0.0001），两组中最常见的病变是肝血管瘤。SLE 与单个血管瘤的存在相关（比值比 5.05；95%置信区间 1.91-13.38）和多个血管瘤（比值比 4.13；95%置信区间 1.03-16.55）。多个血管瘤与 SLE 病程较长相关（9.9 ± 6.5 比 5.5 ± 6.4 年；P = 0.04）。在 9 例 SLE 伴血管瘤的患者中，有 7/9 在 SLE 发病前的影像学检查中无病变。我们患者的临床资料提示 SLE 可能在血管瘤的发生中起作用。此外，还观察到与结节性再生性增生（NRH）相关的 Budd-Chiari 综合征，以及与肝血管瘤相关的 NRH，均发生在因腹部症状住院的患者中，提示在该人群中应专门检查血管性肝病。
SLE 与肝血管瘤的发生风险增加 5 倍相关，提示这些病变可能被视为 SLE 的肝表现之一。
