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Evaluation of liver function tests in scleroderma patients

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Abstract

Systemic sclerosis is a clinically heterogeneous, systemic disorder which affects the connective tissue of the skin, internal organs, and the walls of blood vessels. It is characterized by alterations of the microvasculature, disturbances of the immune system and by massive deposition of collagen and other matrix substances in the connective tissue. This study was done to evaluate the frequency of liver disease in patients with scleroderma and, secondarily, to study the frequency of infection of hepatitis B and C virus in these patients and determine frequency of serum auto-antibodies in this disease. We studied patients with scleroderma, localized or systemic, in the outpatient clinic of rheumatology and dermatology departments, at King Khalid University Hospital. As for a comparison, healthy persons coming to the clinic with the same mean age were considered as control group. Forty patients with the diagnosis of scleroderma included in this work, 35% had elevated gamma-glutamyl-transferase (γ-GT), 30% had elevated alkaline phosphatase (AP) and in 17.5%, the alanine-amino-transferase (ALT) was above the reference values. The ALT had changed to be more in scleroderma patients than in controls. Twenty percent (20%) of the patients tested positive for anti-smooth muscle antibodies (anti-SMA) and only one patient had anti-mitochondrial antibodies (AMA). There was no statistical difference between the two groups regarding antibody testing. Anti-HCV antibodies were observed in one patient, and HBsAg was detected in another scleroderma patient. There was no patient with clinically significant hepatic disease. In this study, although changes in liver enzymes in patients with scleroderma were not uncommon, there was no scleroderma patient with clinical manifestations of liver disease.

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References

  1. Haustein UF (2002) Systemic sclerosis–Scleroderma. Dermatol Online J 8(1):3

    PubMed  Google Scholar 

  2. Le Roy EC, Black C, Fleischmajer R et al (1988) Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol 15:202–205

    CAS  Google Scholar 

  3. Sackner MA (1962) The visceral manifestations of scleroderma. Arthritis Rheum 5:184–196

    Article  PubMed  CAS  Google Scholar 

  4. Miller F, Lane B, Soterakis J, D’Angelo WA (1979) Primary biliary cirrhosis and scleroderma. The possibility of a common pathogenetic mechanism. Arch Pathol Lab Med 103:505–509

    PubMed  CAS  Google Scholar 

  5. Preliminary criteria for the classification of systemic sclerosis (scleroderma) (1980) Subcommittee for scleroderma criteria of the american rheumatism association diagnostic and therapeutic criteria committee. Arthritis Rheum 23(5):581–590

    Article  Google Scholar 

  6. Maricq HR, Harper FE, Khan MM (1983) Microvascular abnormalities as possible predictors of disease subsets in Raynaud’s phenomenon and early connective tissue disease. Clin Exp Rheumatol 1:195–205

    PubMed  CAS  Google Scholar 

  7. Silman AJ (1991) Epidemiology of scleroderma. Ann Rheum Dis 50:846–853

    Article  PubMed  Google Scholar 

  8. Steen VD, Medsger TA Jr (2000) Severe organ involvement in systemic sclerosis with diffuse scleroderma. Arthritis Rheum 11:2437–2444

    Article  Google Scholar 

  9. Bartholomew LG, Cain JC, Winkelmann RK, Baggenstoss AH (1964) Chronic disease of the liver associated with systemic scleroderma. Am J Dig Dis 9:43–55

    Article  PubMed  CAS  Google Scholar 

  10. Clarke AK, Galbraith RM, Hamilton EBD, Williams R (1978) Rheumatic disorders in primary biliary cirrhosis. Ann Rheum Dis 37:42–47

    Article  PubMed  CAS  Google Scholar 

  11. Makinen D, Fritzler JM, Davis P, Sherlock S (1983) Anticentromere antibodies in primary biliary cirrhosis. Arthritis Rheum 26:914–917

    Article  PubMed  CAS  Google Scholar 

  12. D’Angelo WA, Fries JF, Masi AT, Shulman LE (1969) Pathologic observations in systemic sclerosis (scleroderma). A study of fifty-eight autopsy cases and fifty-eight matched controls. Am J Med 46(3):428–440

    Article  PubMed  Google Scholar 

  13. Murray Lyon IM, Thompson RP, Ansell ID, Williams R (1970) Scleroderma and primary biliary cirrhosis. Br Med J 1:258–259

    Article  Google Scholar 

  14. Goetz RH, Berne MB (1945) The pathology of progressive systemic sclerosis (generalized scleroderma): with special reference to changes in the viscera. Clin Proc 4:337–392

    Google Scholar 

  15. Reynolds TB, Denison EK, Frankl HD, Lieberman FL, Peters RL (1970) New syndrome. Combination of primary biliary cirrhosis, scleroderma and hereditary hemorrhagic teliangectasia. Gastroenterology 58:290

    Google Scholar 

  16. Gonzalez-Lopez MA, Drake M, Gonzalez-Vela MC, Armesto S, Llaca HF, Val-Bernal JF (2006) Generalized morphea and primary biliary cirrhosis coexisting in a male patient. J Dermatol 33(10):709–713

    Article  PubMed  Google Scholar 

  17. Khalifa M, Ben Jazia E, Hachfi W, Sriha B, Bahri F, Letaief A (2006) Autoimmune hepatitis and morphea: a rare association. Gastroenterol Clin Biol 30(6–7):917–918

    Article  PubMed  Google Scholar 

  18. Marie I, Levesque H, Tranvouez JL et al (2001) Autoimmune hepatitis and systemic sclerosis: a new overlap syndrome? Rheumatology (Oxford) 40(1):102–106

    Article  CAS  Google Scholar 

  19. Kaburaki J, Kuramochi S, Fujii T et al (1996) Nodular regenerative hyperplasia of the liver in a patient with systemic sclerosis. Clin Rheumatol 15(6):613–616

    Article  PubMed  CAS  Google Scholar 

  20. Fraile G, Rodriguez-Garcia JL, Moreno A (1991) Primary sclerosing cholangitis associated with systemic sclerosis. Postgrad Med J 67(784):189–192

    Article  PubMed  CAS  Google Scholar 

  21. Le Roy EC, Medsger TA Jr (2001) Criteria for the classification of early systemic sclerosis. J Rheumatol 28:1573–1576

    CAS  Google Scholar 

  22. Okano Y (1996) Antinuclear antibody in systemic sclerosis (scleroderma). Rheum Dis Clin North Am 22:709–735

    Article  PubMed  CAS  Google Scholar 

  23. Fanning GC, Welsh KI, Bunn C, Du Bois R, Black CM (1998) HLA associations in three mutually exclusive autoantibody subgroups in UK systemic sclerosis patients. Br J Rheumatol 37:201–207

    Article  PubMed  CAS  Google Scholar 

  24. Harvey GR, McHugh NJ (1999) Serologic abnormalities in systemic sclerosis. Curr Opin Rheumatol 11:495–502

    Article  PubMed  CAS  Google Scholar 

  25. Moroi Y, Peebles C, Fritzler MJ, Steigerwald J, Tan EM (1980) Autoantibody to centromere (kinetochore) in scleroderma sera. Proc Natl Acad Sci USA 77:1627–1631

    Article  PubMed  CAS  Google Scholar 

  26. Abraham S, Begum S, Isenberg D et al (2004) Hepatic manifestations of autoimmune rheumatic diseases. Ann Rheum Dis 63(2):123–129

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Gehan Ibrahim Abdelrazek Salem.

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Salem, G.I.A., Abdulrahman, A.A. Evaluation of liver function tests in scleroderma patients. Rheumatol Int 32, 2371–2375 (2012). https://doi.org/10.1007/s00296-011-1963-2

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