Adiga Avinash, Nugent Kenneth
Department of Internal Medicine, Texas tech University health Sciences Center, Lubbock, Texas.
Department of Internal Medicine, Texas tech University health Sciences Center, Lubbock, Texas.
Am J Med Sci. 2017 Apr;353(4):329-335. doi: 10.1016/j.amjms.2016.10.014. Epub 2016 Nov 4.
Liver dysfunction occurs in approximately 50% of patients with systemic lupus erythematosus (SLE), and patients with SLE and elevated liver enzymes can present a complicated and difficult differential diagnosis. Lupus hepatitis and autoimmune hepatitis are 2 immunologic conditions involving the liver, which can have similar clinical, laboratory and systemic presentations, leading to difficulties in diagnosis. Physicians need to be aware of these 2 hepatic diseases as diagnosis and appropriate therapy need to occur early in the disease course to prevent progression to advanced liver disease. We review the liver diseases associated with SLE and discuss the approach to the diagnostic evaluation of these patients. In particular, differentiation between lupus hepatitis and autoimmune hepatitis requires careful clinical and often histologic evaluation.
约50%的系统性红斑狼疮（SLE）患者会出现肝功能障碍，而SLE患者且伴有肝酶升高时，其鉴别诊断复杂且困难。狼疮性肝炎和自身免疫性肝炎是两种累及肝脏的免疫性疾病，它们在临床、实验室检查及全身表现上可能相似，从而导致诊断困难。医生需要了解这两种肝脏疾病，因为在疾病早期进行诊断并采取适当治疗，对于预防疾病进展至晚期肝病至关重要。我们回顾了与SLE相关的肝脏疾病，并讨论了对这些患者进行诊断评估的方法。特别是，狼疮性肝炎和自身免疫性肝炎的鉴别需要仔细的临床评估，且往往需要组织学评估。
