Zeitschrift für Rheumatologie

, Volume 64, Issue 1, pp 26–31

Leber und Rheuma

  • C. Wiegard
  • A. W. Lohse
BEITRAG ZUM SCHWERPUNKTTHEMA

Zusammenfassung

Zwischen rheumatischen Erkrankungen und der Leber bestehen vielfältige Beziehungen, obwohl die Leber ein Organ ist, welches besonders selten bei rheumatischen Erkrankungen klinisch relevant mitbeteiligt ist. Bei weitem die häufigste Problematik im Zusammenhang „Leber und Rheuma“ ist der Befund erhöhter Leberwerte bei Patienten unter einer Therapie mit nichtsteroidalen Antirheumatika und/oder systemischer Immunsuppressiva. Wenn auch die häufigste Ursache dieser Form der Hepatopathie eine medikamenten-toxische oder medikamenten-allergische Reaktion ist, so ist es im Einzelfall extrem wichtig, die Differentialdiagnose zu kennenund zu klären, weil auch eine eigenständige Lebererkrankung vorliegen kann. Zufällig oder kausal assoziierte Lebererkrankungen können erhebliche Auswirkungen auf die Therapie haben, da einerseits die Hepatopathie Ursache der rheumatischen Erkrankung sein kann (z. B. virusinduzierte Vaskulitiden, Hämochromatose), andererseits die Lebererkrankung eine wesentliche Kontraindikation für eine anti-rheumatische Therapie sein kann bzw. eine spezifische hepatologische Therapie einer Immunsuppression vorangehenmuss (z. B. anti-virale Therapie bei Hepatitis B vor geplanter Immunsuppression).

Schlüsselwörter

Leber Rheumatische Erkrankungen Autoimmune Hepatitis Virushepatitis 

Liver and rheumatism

Summary

There are multiple relations between rheumatic diseases and the liver, nevertheless the liver is extremely rare involved in rheumatic diseases. “Elevated liver enzymes” are quite often found in patients who are under the medication with immunsuppressive drugs or/and non-steroidal antirheumatics. The most frequent cause for “elevated liver enzymes” are toxic and allergic side effects of drugs; however, in rare cases it might be extremly helpful to examine, whether an independent liver disease exists. Underlying liver diseases which might be associated with the rheumatic disorder or exist accidentially may change the therapeutic management of the patient. If the liver disease present can cause the rheumatic disorder (e. g. virus-induced vasculitis, hemochromatosis), a specific hepatological therapy should precede the immunsuppression.

Key words

Liver rheumatic diseases autoimmune hepatitis viral hepatitis 

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Copyright information

© Steinkopff Verlag 2005

Authors and Affiliations

  • C. Wiegard
    • 1
  • A. W. Lohse
    • 1
  1. 1.I. Medizinische KlinikUniversitätsklinikum Hamburg-EppendorfHamburgGermany

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