A patient with systemic lupus erythematosus (SLE) may develop a hepatitis.
NOTE: This diagnosis overlaps with the diagnosis of autoimmune hepatitis.
Clinical features:
(1) active SLE with low complement and immune markers (ANA, anti-ds DNA, anti-Smith)
(2) evidence of hepatitis with elevated liver function tests (serum ALT)
(3) variable jaundice
Immunohistochemical staining may show deposits of complement 1q.
The patient can have a fulminant hepatitis with the need for liver transplantation if the inflammation cannot be controlled.
The diagnosis requires exclusion of other causes of hepatitis:
(1) alcohol
(2) viral hepatitis A, B and C
(3) toxic hepatitis
(4) autoimmune hepatitis (with or without overlap syndrome)
To read more or access our algorithms and calculators, please log in or register.
Specialty: Immunology/Rheumatology
