Grover Shrruti, Rastogi Archana, Singh Jyotsna, Rajbongshi Apurba, Bihari Chhagan
Department of Pathology, Institute of Liver and Biliary Sciences D-1, Vasant Kunj, New Delhi 110070, India.
Hepat Res Treat. 2014;2014:562979. doi: 10.1155/2014/562979. Epub 2014 Jul 21.
Collagen vascular diseases (CVDs) like systemic lupus erythematosus (SLE), rheumatoid arthritis, Sjogren syndrome (SS), and scleroderma are immunologically mediated disorders that typically have multisystem involvement. Although clinically significant liver involvement is rare, liver enzyme abnormalities are common in these patients. The reported prevalence of hepatic involvement in SLE, histopathologic findings, and its significance is very variable in the existing literature. It is important to be familiar with the causes of hepatic involvement in SLE along with histomorphological features which aid in distinguishing hepatitis of SLE from other hepatic causes as they would alter the patient management and disease course. Histopathology of liver in SLE shows a wide morphological spectrum commonly due to a coexisting pathology. Drug induced hepatitis, viral etiology, and autoimmune overlap should be excluded before attributing the changes to SLE itself. Common histopathologic findings in SLE include fatty liver, portal inflammation, and vascular changes like hemangioma, congestion, nodular regenerative hyperplasia, arteritis, and abnormal vessels in portal tracts.
像系统性红斑狼疮（SLE）、类风湿性关节炎、干燥综合征（SS）和硬皮病这样的胶原血管疾病（CVDs）是免疫介导的疾病，通常累及多个系统。虽然临床上显著的肝脏受累很少见，但这些患者中肝酶异常很常见。现有文献中关于SLE肝脏受累的报道患病率、组织病理学发现及其意义差异很大。熟悉SLE肝脏受累的原因以及有助于将SLE肝炎与其他肝脏病因区分开来的组织形态学特征很重要，因为它们会改变患者的管理和疾病进程。SLE肝脏的组织病理学表现出广泛的形态学谱，通常是由于并存的病理情况。在将这些变化归因于SLE本身之前，应排除药物性肝炎、病毒病因和自身免疫重叠。SLE常见的组织病理学发现包括脂肪肝、门脉炎症以及血管变化，如血管瘤、充血、结节性再生性增生、动脉炎和门脉区异常血管。
