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

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Summary

Introduction

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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