The Korean Journal of Medicine

  • 제80권3호
  • /
  • Pages.360-364
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  • 2011
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  • 1738-9364(pISSN)
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  • 2289-0769(eISSN)
대한내과학회 (The Korean Association of Internal Medicine)
권호 표지

전신성 홍반성 루푸스 환자에서 발생한 루푸스 간염 1예

A Case of Lupus-Related Hepatitis Mimicking Autoimmune Hepatitis

  • 이양원 (가톨릭대학교 의과대학 내과학교실) ;
  • 김지민 (가톨릭대학교 의과대학 내과학교실) ;
  • 김윤경 (가톨릭대학교 의과대학 내과학교실) ;
  • 문수진 (가톨릭대학교 의과대학 내과학교실) ;
  • 윤호성 (가톨릭대학교 의과대학 내과학교실) ;
  • 김호연 (가톨릭대학교 의과대학 내과학교실) ;
  • 박성환 (가톨릭대학교 의과대학 내과학교실)
  • Lee, Yang-Won (Department of Internal Medicine, The Catholic University of Korea School of Medicine) ;
  • Kim, Ji-Min (Department of Internal Medicine, The Catholic University of Korea School of Medicine) ;
  • Kim, Yun-Kyeong (Department of Internal Medicine, The Catholic University of Korea School of Medicine) ;
  • Moon, Su-Jin (Department of Internal Medicine, The Catholic University of Korea School of Medicine) ;
  • Yoon, Ho-Sung (Department of Internal Medicine, The Catholic University of Korea School of Medicine) ;
  • Kim, Ho-Youn (Department of Internal Medicine, The Catholic University of Korea School of Medicine) ;
  • Park, Sung-Hwan (Department of Internal Medicine, The Catholic University of Korea School of Medicine)
  • 발행 : 2011.03.01
⟨ 이전 논문 다음 논문 ⟩

초록

전신성 홍반성 루푸스 자체에 의한 간염은 드물게 발생하며, 자가면역성 간염과 감별을 요한다. 저자들은 자가면역성 간염과 유사하게 표현된 루푸스 간염에서 간 조직검사의 중요성을 경험하였기에 문헌고찰과 함께 보고하는 바이다.

Patients with systemic lupus erythematosus (SLE) have a 25% to 50% incidence of abnormal findings on liver function tests. The main causes of abnormal liver function in patients with SLE are viral hepatitis, drug-induced toxic hepatitis, and fatty liver. However, hepatic involvement due to the pathogenic process of SLE is rare. In such conditions, lupus-related hepatitis must be distinguished from autoimmune hepatitis, which is a type of primary liver disease characterized by similar clinical manifestations and autoimmune profiles. Relationships between hepatic involvement of SLE and autoimmune hepatitis remain to be elucidated. We report a case of lupus-related hepatitis mimicking autoimmune hepatitis.

키워드

참고문헌

  1. Lu MC, Li KJ, Hsieh SC, Wu CH, Yu CL. Lupus-related advanced liver involvement as the initial presentation of systemic lupus erythematosus. J Microbiol Immunol Infect 2006;39:471-475.
  2. Miller MH, Urowitz MB, Gladman DD, Blendis LM. The liver in systemic lupus erythematosus. Q J Med 1984;53:401-409.
  3. Yoon JU, Park SH, Kim EJ, et al. Two cases of autoimmune hepatitis associated with systemic lupus erythematosus. Korean J Hepatol 2003;9:231-235.
  4. Chang HK, Kim SY, Park YS. A case of autoimmune hepatitis associated with systemic lupus erythematosus. J Korean Rheum Assoc 2000;7:410-414.
  5. Park KT, Kim KY, Kim IY, et al. A case of autoimmune hepatitis accompanied by systemic lupus erythematosus. Korean J Med 2007;72:160-163.
  6. Johnson PJ, McFarlane IG. Meeting report: International Autoimmune Hepatitis Group. Hepatology 1993;18:998-1005. https://doi.org/10.1002/hep.1840180435
  7. Hochberg MC. Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 1997;40:1725.
  8. Oka H. The survey of autoimmune hepatitis in Japan. Annual report of the study group on severe hepatitis. Japanese Ministry of Health and Welfare 1988;235-241.
  9. Chowdhary VR, Crowson CS, Poterucha JJ, Moder KG. Liver involvement in systemic lupus erythematosus : case review of 40 patients. J Rheumatol 2008;35:2159-2164. https://doi.org/10.3899/jrheum.080336
  10. Obermayer-Straub P, Strassburg CP, Manns MP. Autoimmne hepatitis. J Hepatol 2000;32(1 Suppl):S181-S197.
  11. Kaw R, Gota C, Bennett A, Barnes D, Calabrese L. Lupus-related hepatitis: complication of lupus or autoimmune association? Case report and review of the literature. Dig Dis Sci 2006;51:813-818. https://doi.org/10.1007/s10620-006-3212-1
  12. Usta Y, Gurakan F, Akcoren Z, Ozen S. An overlap syndrome involving autoimmune hepatitis and systemic lupus erythematosus in childhood. World J Gastroenterol 2007;13:2764-2767.
  13. Malnick S, Melzer E, Sokolowski N, Basevitz A. The involvement of the liver in systemic diseases. J Clin Gastroenterol 2008;42:69-80. https://doi.org/10.1097/MCG.0b013e318135442e
  14. Elkon KB, Parnassa AP, Foster CL. Lupus antoantibodies target ribosomoal P proteins. J Exp Med 1985;162:459-471. https://doi.org/10.1084/jem.162.2.459
  15. Hulsey M, Goldstein R, Scully L, Surbeck W, Reichlin M.. Anti-ribosomal P antibodies in systemic lupus erythematosus: a case-control study correlating hepatic and renal disease. Clin Immunol Immunopathol 1995;74:252-256. https://doi.org/10.1006/clin.1995.1037
  16. Bonfa E, Golombek SJ, Kaufman LD, et al. Association between lupus psychosis and anti-ribosomal P protein antibodies. N Engl J Med 1987;317:265-271. https://doi.org/10.1056/NEJM198707303170503
  17. Teh LS, Isenberg DA. Antiribosomal P protein antibodies in systemic lupus erythematosus: a reappraisal. Arthritis Rheum 1994;37:307-315. https://doi.org/10.1002/art.1780370303
  18. Koren E, Schnitz W, Reichlin M. Concomitant development of chronic active hepatitis and antibodies to ribosomal P proteins in a patient with systemic lupus erythematosus. Arthritis Rheum 1993;36:1325-1328. https://doi.org/10.1002/art.1780360917
  19. Czaja AJ. Behavior and significance of autoantibodies in type 1 autoimmune hepatitis. J Hepatol 1999;30:394-401. https://doi.org/10.1016/S0168-8278(99)80096-8
  20. Gladman DD, Ibanez D, Urowitz MB. Systemic lupus erythematosus disease activity index 2000. J Rheumatol 2002;29:288-291.