Abstract
Aim Cirrhosis is rare in systemic lupus erythematosus (SLE) patients with a poor prognosis. This study is aimed at retrospectively analyzing our single-center experience to explore the characteristics of cirrhosis in SLE patients. Methods SLE patients with cirrhosis from 2012 to 2019 were enrolled. SLE diagnosis was rigorously confirmed by a medical record review according to the revised 1997 American College of Rheumatology classification criteria for SLE. The diagnosis of liver cirrhosis was based on a combination of clinical, laboratory, and imaging criteria features. We conducted a case-control study in SLE patients complicated with the cirrhosis group and the age-, sex-, and entry-time-matched noncirrhosis group. Results A total of 21 patients with SLE cirrhosis were enrolled, 3 males and 18 females. The median age at the time of cirrhosis diagnosis was 47.3 ± 4.0 years, and the mean disease duration of SLE before cirrhosis was 4.7 ± 1.0 years. The most common initial presentation was the involvement of the hematological system in 9 patients and then skin and mucosal involvement in 5 patients, arthritis in 4 patients, and nephritis in 3 patients. Patients with cirrhosis had a significantly higher rate of hematological system involvement (thrombocytopenia and leukopenia) and worse liver function; a higher level of immune globulin G had higher mortality (p < 0.05) than patients without cirrhosis. Conclusions Cirrhosis is a rare and severe subtype of SLE with a poor prognosis. Those patients with hematological system involvement and impaired liver function should be paid more attention.
Highlights
The systemic lupus erythematosus (SLE) is an autoantibodymediated, diffuse connective tissue disease with extremely variable and heterogeneous clinical presentation
We present a case-controlled study, matched by age and gender, to discover the clinical characteristics of systemic lupus erythematosus with cirrhosis
21 patients were included as the cirrhosis group, 18 females and 3 males
Summary
The systemic lupus erythematosus (SLE) is an autoantibodymediated, diffuse connective tissue disease with extremely variable and heterogeneous clinical presentation. The liver is a lymphoid organ involved in the immune response [1] and a target of autoimmune reactions. Advanced liver disease with cirrhosis and liver failure is rare in patients with connective tissue diseases. The liver may be involved in 19.4% to 60% of patients with SLE at some point during the diseases, of which cirrhosis only accounts for about 1-2% [2,3,4]. Few studies have reported data of cirrhosis in SLE. We conduct this casecontrol study to explore the clinical characteristics of systemic lupus erythematosus with cirrhosis
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