[A young male of systemic lupus erythematosus with hepatic lesions showing multiple low density spots in CT of liver].

A 19-year-old man was admitted to our hospital due to low grade fever and polyarthralgia with history of photosensitivity. Laboratory findings showed the elevated transaminases, leukocytopenia and thrombocytopenia. Examinations in regard to autoimmune diseases revealed the positive antinuclear antibody and positive LE test. The computed tomography (CT) showed the multiple low density spots in liver. CT guided liver biopsy specimens regarding to these low density spots showed the hepatic lesions with mild inflammatory cell infiltration and subtle piecemeal necrosis. The patient was diagnosed as systemic lupus erythematosus (SLE) with hepatic lesions based on the clinical symptoms and the laboratory data. Rheumatoid arthritis was excluded because of intact joints X-ray findings. Autoimmune hepatitis was also denied because of the fulfillment of definite diagnostic criteria of SLE and minimal histological changes of liver. Prednisolone therapy improved his clinical manifestations and normalized both the laboratory data of liver function and the immunological abnormalities in SLE, so the multiple spots in CT of liver also disappeared.