Liver disease in patients with joint symptoms.
نویسندگان
چکیده
It is well established that hepatic abnormalities may occur in patients with rheumatoid arthritis (RA) and other connective tissue disorders and these changes have usually been attributed to the systemic nature of the underlying disease process. Abnormalities reported include minor derangements of liver function (Movitt and Davis, 1953) and other abnormalities which have been related to the severity of the associated rheumatoid disease (Lefkovits and Farrow, 1955; Kendall, Cockel, Becker, and Hawkins, 1970). Indices of hepatic derangement have included raised alkaline phosphatase/5-nucleotidase levels (Kendall and others, 1970; Kendall, Farr, Bold, and Hawkins, 1971; Cockel, Kendall, Becker, and Hawkins, 1971) and the detection of mitochondrial antibodies (Walker, Doniach, and Doniach, 1970; Whaley, Goudie, Williamson, Nuki, Dick, and Buchanan, 1970). Histological changes have been noted, such as infiltration of the portal tracts by chronic inflammatory cells (Lefkovits and Farrow, 1955; Schaller, Beckwith, and Wedgwood, 1970) and fatty change (Movitt and Davis, 1953). In juvenile rheumatoid arthritis, hepatomegaly and derangement of liver function is well documented and hepatic histology has shown nonspecific infiltration of inflammatory cells in the portal tracts and hyperplasia of Kupffer cells (Schaller and others, 1970; Kornreich, Malouf, and Hanson, 1971). Walker and others (1970), in a study of thirty-five hospital patients found on screening to have mitochondrial antibodies, identified ten patients with subclinical liver disease. Of these ten patients, nine had rheumatological disorders (including two patients with RA, two with systemic lupus erythematosus, three with polyarthralgia, and one each with polymyalgia rheumatica and osteoarthrosis). Eight of these ten patients had liver biopsies which showed hepatitis of varying degree. We report a group of thirty patients, who presented at a rheumatology clinic with symptoms relating to the locomotor system and who were found on routine clinical examination or biochemical screening to have hepatomegaly and/or abnormal routine liver function tests. Detailed hepatic investigations were performed in these patients to determine the cause and significance of these findings.
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ورودعنوان ژورنال:
- Annals of the rheumatic diseases
دوره 33 6 شماره
صفحات -
تاریخ انتشار 1974