Chronic hepatitis during rheumatoid arthritis.
Chronic hepatitis is infrequently reported in the course of RA (1.9%). We report 6 cases with such an association. The six patients were all female (mean age: 59.5 years) with typical RA (ACR criteria), and sicca syndrome in 5 cases. Chronic hepatitis always developed after the onset of RA (delay: 1 to 47 years). Laboratory findings revealed a mild increase of transaminases. Alkaline phosphatase were increased in 3 cases. Liver insufficiency was present in 4 cases and polyclonal hypergammaglobulinemia in 6 cases. Rheumatoid factors were detected in 5 cases; antinuclear antibodies and anti-smooth muscle antibodies were also detected in 5 cases. Histological examination of liver biopsy disclosed active chronic hepatitis in 5 cases (with cirrhosis in 3 cases) and persistent chronic hepatitis in 1 case. Steroid therapy was administered in 4 cases of active chronic hepatitis with clinical and biological improvement (18 months to 6 years follow-up). One patient died of gastric bleeding.
Job-Deslandre
C
C
Service de Rhumatologie A, Hôpital Cochin, Paris, France.
Feldmann
J L
JL
Djian
Y
Y
Menkes
C J
CJ
D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D000469:Alkaline Phosphatase / Q000097:blood; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000188:drug therapy / Q000201:enzymology; D001219:Aspartate Aminotransferases / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006505:Hepatitis / Q000188:drug therapy / Q000201:enzymology / Q000209:etiology*; D006801:Humans; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D012217:Rheumatoid Factor / Q000032:analysis
D000894:Anti-Inflammatory Agents, Non-Steroidal; D012217:Rheumatoid Factor; D011239:Prednisolone; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D000469:Alkaline Phosphatase