title: Abnormal hepatic biochemistries and clinical liver disease in patients with primary Sjögren's syndrome.
abstract: OBJECTIVE
  Patients with primary Sjögren's syndrome may present liver involvement. Our goals were to establish the prevalence of abnormal hepatic biochemistries and clinical liver disease in patients with primary Sjögren's syndrome and correlate their presence with other clinical and laboratory features.
  
  
  METHODS
  Ninety-five patients with diagnosis of primary Sjögren's syndrome were studied. Data on gender, age, clinical features, liver biochemistries, tests of inflammation and autoimmunity, and concomitant diseases were collected.
  
  
  RESULTS
  Forty-two patients (44%) had abnormal hepatic biochemistries, and of these 19 patients (20%) had clinical liver disease. Patients with abnormal hepatic biochemistries had higher frequency of autoimmune hypotiroidism, arthritis, vasculitis, Raynaud's phenomenon, higher sedimentation rate,and higher frequency of antinuclear and antimitochondrial antibodies than patients with normal liver biochemistries (P < 0.05 for each). Patients with clinical liver disease had higher frequency of arthritis, vasculitis, and higher frequency of antimitochondrial antibodies than patients without clinical liver disease (P < 0.05 for each). Twenty-one patients had diagnosis of a specific liver disease, such as hepatitis C virus infection (n = 11), autoimmune hepatitis (n = 2), primary biliary cirrhosis (n =5),nonalcoholic fatty liver disease (n = 2), and hepatitis B virus infection (n = 1). In half of patients with liver involvement a definitive cause could not be identified.
  
  
  CONCLUSIONS
  Liver involvement is frequently found in patients with primary Sjögren's syndrome, and its presence is associated with clinical features of systemic disease, and markers of autoimmunity and inflammation. There may be a subgroup of patients with liver involvement secondary to primary Sjögren's syndrome.
authors.affiliation: Department of Gastroenterology and Hepatology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico. montanoa@quetzal.innsz.mx
authors.forename: Aldo J
authors.initials: AJ
authors.lastname: Montaño-Loza
authors.forename: José Carlos
authors.initials: JC
authors.lastname: Crispín-Acuña
authors.forename: José María
authors.initials: JM
authors.lastname: Remes-Troche
authors.forename: Misael
authors.initials: M
authors.lastname: Uribe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015551:Autoimmunity / Q000502:physiology; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology; D008099:Liver / Q000378:metabolism*; D008107:Liver Diseases / Q000209:etiology* / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D012859:Sjogren's Syndrome / Q000150:complications* / Q000378:metabolism