title: A close temporal relationship of liver disease to antiribosomal P0 protein antibodies and central nervous system disease in patients with systemic lupus erythematosus.
abstract: OBJECTIVE
  To determine whether there is a close temporal relationship of liver disease to serum IgG and/or IgM antiribosomal P0 protein antibodies (anti-P0) and central nervous system (CNS) lupus in patients with systemic lupus erythematosus (SLE).
  
  
  METHODS
  The study included 70 patients with active SLE. Of these, 30 had IgG and/or IgM anti-P0 and 14 had CNS lupus other than psychiatric disease (nonpsychiatric CNS lupus). Of these 14 patients, 11 had anti-P0. Laboratory manifestations of liver disease were retrospectively analyzed.
  
  
  RESULTS
  Liver disease not attributed to any cause other than SLE (SLE liver disease) was present in 8 of the 11 patients with anti-P0 with nonpsychiatric CNS lupus (72.7%), in none of the 19 patients with anti-P0 without nonpsychiatric CNS lupus (0%), and in one of the 40 patients without anti-P0 (2.5%). The prevalence of SLE liver disease was significantly greater in patients with anti-P0 with nonpsychiatric CNS lupus than in the other 2 groups (p < 0.0001). Mean levels of liver enzymes (lactate dehydrogenase, glutamic oxaloacetic transaminase, glutamate pyruvate transaminase, gammaglutamyl transpeptidase) were significantly higher in patients with anti-P0 with nonpsychiatric CNS lupus than in the other 2 groups. Serial studies in 3 patients showed that the appearance of anti-P0 and liver dysfunction slightly preceded the onset of nonpsychiatric CNS lupus.
  
  
  CONCLUSIONS
  Anti-P0 may be related to the pathogenesis of CNS lupus and SLE liver disease found simultaneously in SLE. The appearance of anti-P0 and liver dysfunction may predict onset of CNS lupus.
authors.affiliation: Department of Medicine, Jichi Medical School, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Yoshio
authors.forename: J I
authors.initials: JI
authors.lastname: Masuyama
authors.forename: S
authors.initials: S
authors.lastname: Minota
authors.forename: N
authors.initials: N
authors.lastname: Kaneko
authors.forename: M
authors.initials: M
authors.lastname: Iwamoto
authors.forename: H
authors.initials: H
authors.lastname: Okazaki
authors.forename: A
authors.initials: A
authors.lastname: Mimori
authors.forename: A
authors.initials: A
authors.lastname: Takeda
authors.forename: S
authors.initials: S
authors.lastname: Kano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002493:Central Nervous System Diseases / Q000150:complications / Q000276:immunology*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D008107:Liver Diseases / Q000150:complications / Q000276:immunology*; D008180:Lupus Erythematosus, Systemic / Q000150:complications / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010750:Phosphoproteins / Q000276:immunology*; D012269:Ribosomal Proteins / Q000276:immunology*; D013997:Time Factors
chemical_list: D007074:Immunoglobulin G; D007075:Immunoglobulin M; D010750:Phosphoproteins; D012269:Ribosomal Proteins; C054675:ribosomal protein P0