AB0562 LIVER ENZYME ABNORMALITIES IN HOSPITALIZED LUPUS PATIENTS – A RETROSPECTIVE STUDY

Background Around 25% to 50% of lupus patients may present with alterations in the liver enzymes variable severity including fulminant hepatic failure. 1 Objectives To study prevalence, aetiology and outcome hospitalized enzyme abnormalities. Methods We analysed all from June 2018–June 2021. Patients abnormal enzymes(>2 times Upper Limit Normal) 2 were identified categorized as per standard definitions/criteria. 3,4 The outcomes association mortality was analysed. Results Liver available 461/535 hospitalisations amongst 383 whom abnormalities detected 95/461 (20.6%). Among 77 elevated transaminases, 33/77(42.9%) fulfilled criteria for macrophage activation syndrome (MAS) HLH parodie et.al 4 . Other aetiologies are represented Table 1. Overall rate 12/77(15.58%), highest being MAS 9/12(75%). Higher aspartate aminotransferase/alanine aminotransferase (AST/ALT) ratio associated adverse MAS. Aetiology associations Aetiologies transaminases Macrophage Lupus activity 16/77(20.8%) Overlap Myositis 12/77(15.6%) Autoimmune Hepatitis 6/77(7.8%) Sepsis 5/77(6.5%) Primary Biliary Cirrhosis 3/77(3.9%) Drugs 2/77(2.6%) Comparison between without among (N=33) No (N=44) P-value Mortality (N= 9/33) (N=24/33) AST 228(169,377.5) (128,281) 0.098 * 265(232.5,545) 209(139.5,360) 0.036* ALT 73(51.5,121.5) 96(54,140) 0.520 58(46,132.5) 94.5(53.5,121.75) 0.505 ALP 202(69.5,382.5) 175(90,318) 0.794 233.5(84,382.2) 202(69.5,407.5) 0.788 GGT 232(77.5, 443) 179(75,333) 0.312 402(139.5,995.7) 202(70.5,373.0) 0.205 AST/ALT RATIO 3.18(1.96,4.45) 2.3(1.4,3.6) 0.016* 4.33 (3.07,6.66) 2.58(1.94,3.64) 0.032* ABBREVATIONS - AST- Aspartate aminotransferase; ALT- Alanine ALP- Alkaline phosphatase, GGT- Gamma glutamyl transferase. Statistically significant *P-value = < 0.05. Conclusion most frequent cause subset higher ratio. References [1]Chowdhary VR, Crowson CS, Poterucha JJ, Moder KG. involvement systemic erythematosus: case review 40 patients. Journal Rheumatology. 2008 Nov 1;35(11):2159-64. [2]Her M, Lee Y, Jung E, Kim T, D. a focus on toxic hepatitis. Rheumatology international. 2011 Jan;31(1):79-84.1. [3]Henter JI, Horne A, Aricó Egeler RM, etal. HLH-2004: diagnostic therapeutic guidelines hemophagocytic lymphohistiocytosis. Pediatric blood & cancer. 2007 Feb;48(2):124-31. [4]Parodi Davì S, Pringe AB, Pistorio juvenile multinational multicenter thirty-eight Arthritis Rheumatism: Official American College 2009 Nov;60(11):3388-99. Disclosure Interests None declared