Liver abnormalities in rheumatic diseases.
Liver abnormalities in rheumatic diseases.
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DOI：
10.1016/s1089-3261(02)00052-1
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发表时间：
2002-11-01
影响因子：
5.1
通讯作者：
Zurier, Robert B
中科院分区：
文献类型：
--
作者：
Walker, Nancy J;Zurier, Robert B
LFTs和肝功能异常在风湿性疾病患者中并不少见，存在许多诊断可能性。与风湿病失控和疾病缓解期有关的全身性炎症被认为是血清转氨酶水平波动的原因。虽然风湿病的这些良性关节外表现是最常见的表现，但在特定的风湿病中也观察到了更严重的肝脏损害，包括血管炎、结节性再生性增生和原发性胆汁性肝硬变。风湿病的病因尚不清楚。隐匿性丙型肝炎病毒感染和相关的冷球蛋白血症可模拟风湿性疾病。混合冷球蛋白血症患者应常规怀疑丙型肝炎病毒感染，特别是因为抗病毒治疗可能是有益的。风湿病的医疗管理涉及到通常对肝脏有毒性的药物。建议常规实验室监测、影像检查，如有必要，在血清转氨酶仍然异常的情况下进行活组织检查。
Abnormalities of LFTs and liver function occur not infrequently in patients with rheumatic conditions, and many diagnostic possibilities exist. Systemic inflammation that is related to uncontrolled rheumatic disease and periods of disease remission have been described as a cause for fluctuations in levels of serum aminotransferases. Although these benign extra-articular manifestations of rheumatic disease are the most common manifestations, more serious hepatic involvement, including vasculitis, nodular regenerative hyperplasia, and primary biliary cirrhosis, have been observed in specific rheumatic diseases. The cause of rheumatic disease is unclear. Occult HCV infection and associated cryoglobulinemia can mimic rheumatic disease. HCV infection should be suspected routinely in patients with mixed cryoglobulinemia, especially because antiviral therapy may be beneficial. The medical management of rheumatic disease involves medications that are often hepatotoxic. Routine laboratory monitoring, imaging studies, and, if necessary, biopsy examination in situations in which serum aminotransferases remain abnormal, are recommended.