van Hoek B
Department of Gastroenterology and Hepatology, University Hospital, Leiden, Netherlands.
Neth J Med. 1996 Jun;48(6):244-53. doi: 10.1016/0300-2977(96)00003-4.
Patients with systemic lupus erythematosus (SLE) have a 25-50% chance of developing abnormal liver tests in their lifetime. This percentage does not include unconjugated hyperbilirubinaemia due to haemolysis associated with SLE, or elevated aspartate-aminotransferase caused by SLE-associated myositis. The most common cause is drug-induced hepatitis, while mild, predominantly lobular-but sometimes also portal and periportal-hepatitis reflecting SLE activity is another possibility. Other liver disease in SLE can be related to thrombotic events, whether or not associated with the lupus anticoagulant, including Budd-Chiari syndrome and veno-occlusive disease. Other liver abnormalities have been more or less frequently associated with SLE, such as nodular regenerative hyperplasia, perihepatitis, and hepatic or splenic rupture. Also viral hepatitis, obstructive jaundice, autoimmune hepatitis, primary biliary cirrhosis, granulomatous hepatitis, cryptococcus infection of the liver, chronic hepatitis with IgA or IgD deficiency, porphyria or idiopathic portal hypertension co-existing with SLE have been described.
系统性红斑狼疮（SLE）患者一生中出现肝功能检查异常的几率为25%至50%。该百分比不包括与SLE相关的溶血导致的非结合性高胆红素血症，或SLE相关肌炎引起的天冬氨酸转氨酶升高。最常见的原因是药物性肝炎，而反映SLE活动的轻度、主要为小叶性但有时也为门脉性和门脉周围性肝炎是另一种可能。SLE中的其他肝脏疾病可能与血栓形成事件有关，无论是否与狼疮抗凝物相关，包括布加综合征和肝静脉闭塞性疾病。其他肝脏异常或多或少经常与SLE相关，如结节性再生性增生、肝周炎以及肝或脾破裂。也有文献描述了病毒性肝炎、阻塞性黄疸、自身免疫性肝炎、原发性胆汁性肝硬化、肉芽肿性肝炎、肝脏隐球菌感染、伴有IgA或IgD缺乏的慢性肝炎、卟啉病或特发性门脉高压与SLE并存的情况。
