title: [Liver involvement in primary Sjogren's syndrome].
abstract: OBJECTIVE
  To determine the prevalence of liver involvement in patients with primary Sjogren's syndrome (SS) and to evaluate the association of this complication with other extra-glandular manifestations and serologic markers.
  
  
  METHODS
  We examined 155 Japanese patients (150 women and 5 men, mean age 66.6 years) who met the European Epidemiology Center Criteria for primary SS. Liver involvement was considered present when abnormal liver function tests (AST, ALT, ALP, GTP, or bilirubin) were detected more than three times.
  
  
  RESULTS
  20 patients (13%) had liver involvement including 2% with clinically overt liver disease. The causes of liver involvement were primary biliary cirrhosis (PBC) 6, autoimmune hepatitis (AIH) 2, hepatitis C virus (HCV) infection 2, concurrence of AIH and HCV infection 1, fatty liver 1. In 8 patients, the cause remained unclear. Of 6 patients complicated with PBC, four patients had PBC-specific antimitochondrial antibodies (AMA). Liver dysfunction was transient in two patients. Hepatocelluar carcinoma developed in a patient whose liver involvement was due to AIH and HCV. Patients with liver involvement were more likely to have cutaneous and neurological manifestations, when compared to SS without liver involvement. A positive antinuclear antibody, rheumatoid factor, and anticentromere antibody were also associated with liver involvement. Other autoantibodies did not correlate with the prevalence of liver involvement.
  
  
  CONCLUSIONS
  Although symptomatic liver involvement is rare in SS patients, asymptomatic liver involvement is common. Clinicians must be aware of the possibility of liver involvement so that it can be treated as soon as possible.
authors.affiliation: National Hospital Organization Yokohama Medical Center.
authors.forename: Akiko
authors.initials: A
authors.lastname: Aoki
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kirino
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Ishigatsubo
authors.forename: Akiko
authors.initials: A
authors.lastname: Senuma
authors.forename: Syohei
authors.initials: S
authors.lastname: Nagaoka
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000150:complications*