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Rheumatologic Diseases and the Liver

Author

Gebreselassie A1, Aduli F2, Howell CD3. Clin Liver Dis. 2019 May;23(2):247-261. doi: 10.1016/j.cld.2018.12.007. Epub 2019 Mar 8.

Author Information

1 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Howard University Hospital, 2041 Georgia Avenue Northwest, Suite 4J19, Washington, DC 20060, USA.

2 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Howard University Hospital and College of Medicine, 2041 Georgia Avenue Northwest, Suite 5C22, Washington, DC 20060, USA.

3 Division of Gastroenterology and Hepatology, Department of Internal Medicine, Howard University Hospital and College of Medicine, 2041 Georgia Avenue Northwest, Suite 5C02, Washington, DC 20060, USA. Electronic address: charles.howell@howard.edu.

Abstract

A variety of rheumatologic disorders may affect the liver. There is a significant epidemiologic, genetic, and immunologic overlap between immune-mediated rheumatologic disorders and autoimmune liver diseases. There is an increased frequency of autoimmune liver diseases, such as primary biliary cholangitis, autoimmune hepatitis, primary sclerosing cholangitis, or overlap syndrome, in patients with systemic lupus erythematosus, rheumatoid arthritis, Sjögren syndrome, systemic sclerosis, vasculitis, and other immune-related diseases. Non-immune-mediated rheumatologic diseases such as gouty arthritis may also have hepatic manifestations. Furthermore, medications used to treat rheumatologic diseases occasionally cause liver dysfunction. Conversely, primary immune-mediated and non-immune-mediated liver disorders may present with rheumatologic manifestations.