The clinical significance of liver disease in systemic lupus erythematosus.

The spectrum of hepatic disease in systemic lupus erythematosus (SLE) ranges from subclinical elevations of liver enzymes to rare reports of hepatic arteritis and infarction. Whether liver disease occurs as a consequence of (or is merely coincident with) lupus activity is not known. In our example, an episode of unexplained acute hepatitis occurred in association with pancytopenia. Both responded to increased doses of prednisone and were believed to be manifestations of SLE. The importance of hepatic disease and its contribution to morbidity and mortality in patients with SLE is controversial. Based on a critical review of the literature, we conclude that, although liver disease in SLE occurs more frequently than previously believed, it is usually limited to asymptomatic hepatomegaly and/or isolated elevations in liver function tests.