Clinic of Gastroenterology and Hepatology, Clinical Centre Nis, Bulevar Dr Zorana Đinđića 48, Niš, Serbia.
Faculty of Medicine, University of Niš, Niš, Serbia.
Rheumatol Int. 2018 May;38(5):715-724. doi: 10.1007/s00296-018-4021-5. Epub 2018 Apr 7.
When liver damage is present in rheumatoid arthritis (RA) patients, it is sometimes difficult to determine whether it is a hepatic manifestation of RA, associated primary liver disease or hepatotoxic liver disease which developed during the treatment of RA. Liver damage during RA is most common in the form of asymptomatic abnormal liver tests. Occasionally, liver damage may progress to cirrhosis. Patients with RA are more susceptible to an associated autoimmune liver disease. Medications used in rheumatology are often hepatotoxic and it is difficult to differentiate between hepatic manifestations of the primary disease and potential hepatotoxicity of the administered medications. The significance of the paper is in the fact that it includes the most relevant and the latest information on this commonly present problem in clinical practice. The aim of the author is to provide comprehensive but at the same time concise data which will be useful to the doctors who come into contact with RA patients with symptomatic or asymptomatic liver disease. Timely diagnosis and treatment of liver disease in RA patients can significantly influence the course and outcome of rheumatoid arthritis.
当类风湿关节炎（RA）患者出现肝损伤时，有时很难确定是 RA 的肝表现，是与原发性肝病相关，还是在治疗 RA 期间发生的肝毒性肝病。RA 期间的肝损伤最常见的形式是无症状的肝试验异常。偶尔，肝损伤可能进展为肝硬化。RA 患者更容易发生相关的自身免疫性肝病。风湿病学中使用的药物通常具有肝毒性，并且难以区分原发性疾病的肝表现和所给予药物的潜在肝毒性。本文的意义在于它包含了关于这一在临床实践中普遍存在的问题的最相关和最新的信息。作者的目的是提供全面但同时简洁的数据，这将对接触有症状或无症状肝病的 RA 患者的医生有用。及时诊断和治疗 RA 患者的肝病可以显著影响类风湿关节炎的病程和结局。
