Autoimmune cholangiopathy associated with systemic lupus erythematosus

Liver. 2002 Apr;22(2):102-6. doi: 10.1034/j.1600-0676.2002.01533.x.

Abstract

We report a 39-year-old female who presented over 11 years with autoimmune cholangiopathy associated with kaleidoscopic manifestations of systemic lupus erythematosus (SLE), including, arthritis, skin changes, pleuritis, diffuse proliferative glomerulonephritis, lymphadenopathy, splenomegaly, hyperglobulinemia, and major depression. While antimitochondrial antibodies (AMA) were absent, antinuclear (ANA) and anti-DNA antibodies were detected in high titres associated with hypocomplementemia. The patient also had vitamin B12 deficiency and antiphospholipid antibodies. The patient required steroids and repeated courses of cyclophosphamide for the management of lupus nephritis, and ursodeoxycholic acid (ursolite) administration resulted in amelioration of cholestatic laboratory abnormalities. This unusual case report and review of literature illustrate that immune liver disease may be an important clinical manifestation of SLE, especially autoimmune cholangiopathy.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anemia, Pernicious / etiology
  • Antibodies, Antinuclear / analysis
  • Antibodies, Antiphospholipid / analysis
  • Antirheumatic Agents / therapeutic use
  • Autoimmune Diseases / drug therapy
  • Autoimmune Diseases / etiology*
  • Autoimmune Diseases / immunology
  • Cyclophosphamide / therapeutic use
  • Drug Therapy, Combination
  • Female
  • Glomerulonephritis, Membranoproliferative / etiology
  • Humans
  • Liver Cirrhosis, Biliary / drug therapy
  • Liver Cirrhosis, Biliary / etiology*
  • Liver Cirrhosis, Biliary / immunology
  • Lupus Erythematosus, Systemic / complications*
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / immunology
  • Treatment Outcome
  • Ursodeoxycholic Acid / therapeutic use

Substances

  • Antibodies, Antinuclear
  • Antibodies, Antiphospholipid
  • Antirheumatic Agents
  • Ursodeoxycholic Acid
  • Cyclophosphamide