Skip to main content
Annals of the Rheumatic Diseases logoLink to Annals of the Rheumatic Diseases
. 1975 Feb;34(1):70–81. doi: 10.1136/ard.34.1.70

Liver disease in rheumatoid arthritis and Sjøgren's syndrome. Prospective study using biochemical and serological markers of hepatic dysfunction.

J Webb, K Whaley, R N MacSween, G Nuki, W C Dick, W W Buchanan
PMCID: PMC1006348  PMID: 1092275

Abstract

Inter-relationships of biochemical and immunological tests of liver function have been studied in a prospective study of 216 patients with rheumatoid arthritis (RA), 32 patients with Sjogren's syndrome, and 27 patients with the sicca syndrome, and these results have been compared with those obtained 289 patients with osteoarthrosis or with a form of seronegative polyarthropathy. In general the prevalence of abnormalities in serum alkaline phosphatase, bromsulphthalein excretion, smooth muscle antibody, and mitochondrial antibody in the former three groups was higher than in patients with osteoarthrosis. Patients with Sjogren's syndrome with RA had a higher prevalence of abnormalities of bromsulphthalein excretion, salivary duct antibody than patients with the sicca syndrome. Patients with RA had a higher pervalence of rheumatoid factor than those with the sicca syndrome. Patients with a positive smooth muscle or mitochondrial antibody were found to have a higher prevalence of hepatomegaly and splenomegaly, of abnormal liver function tests, of other autoantibodies, and of histological abnromalitis of liver than those in whom these tests were negative.

Full text

PDF
81

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BALL J. Rheumatoid arthritis and polyarteritis nodosa. Ann Rheum Dis. 1954 Dec;13(4):277–290. doi: 10.1136/ard.13.4.277. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. BECK J. S. Variations in the morphological patterns of "autoimmune" nuclear fluorescence. Lancet. 1961 Jun 3;1(7188):1203–1205. doi: 10.1016/s0140-6736(61)91944-4. [DOI] [PubMed] [Google Scholar]
  3. Ballantyne F. C., Fleck A., Dick W. C. Albumin metabolism in rheumatoid arthritis. Ann Rheum Dis. 1971 May;30(3):265–270. doi: 10.1136/ard.30.3.265. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Bertram U., Halberg P. Organ antibodies in Sjögren's syndrome. Acta Allergol. 1965;20(6):472–483. doi: 10.1111/j.1398-9995.1965.tb03082.x. [DOI] [PubMed] [Google Scholar]
  5. Blendis L. M., Ansell I. D., Jones K. L., Hamilton E., Williams R. Liver in Felty's syndrome. Br Med J. 1970 Jan 17;1(5689):131–135. doi: 10.1136/bmj.1.5689.131. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Brandt K., Cathcart E. S., Cohen A. S. A clinical analysis of the course and prognosis of forty-two patients with amyloidosis. Am J Med. 1968 Jun;44(6):955–969. doi: 10.1016/0002-9343(68)90095-8. [DOI] [PubMed] [Google Scholar]
  7. CASTENFORS H., HULTMAN E., LOEVGREN O. THE BROMSULPHALEIN-TEST (BSP) AS A MEASURE OF RHEUMATOID ARTHRITIS ACTIVITY. Acta Rheumatol Scand. 1964;10:128–132. doi: 10.3109/rhe1.1964.10.issue-1-4.12. [DOI] [PubMed] [Google Scholar]
  8. CLARK L. C., Jr, BECK E. Plasma alkaline phosphatase activity; normative data for growing children. J Pediatr. 1950 Mar;36(3):335–341. doi: 10.1016/s0022-3476(50)80103-8. [DOI] [PubMed] [Google Scholar]
  9. CRUICKSHANK B., SINCLAIR R. J. A clinical and pathological study of sixteen cases of rheumatoid arthritis with extensive visceral involvement ('rheumatoid disease'). Q J Med. 1956 Jul;25(99):313–332. [PubMed] [Google Scholar]
  10. Cockel R., Kendall M. J., Becker J. F., Hawkins C. F. Serum biochemical values in rheumatoid disease. Ann Rheum Dis. 1971 Mar;30(2):166–170. doi: 10.1136/ard.30.2.166. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Connell M. D., Dinwoodie A. J. Diagnostic use of serum alkaline phosphatase isoenzymes and 5-nucleotidase. Clin Chim Acta. 1970 Nov;30(2):235–241. doi: 10.1016/0009-8981(70)90108-7. [DOI] [PubMed] [Google Scholar]
  12. DARBY P. W. Liver function tests in rheumatoid arthritis. J Clin Pathol. 1956 May;9(2):153–156. doi: 10.1136/jcp.9.2.153. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. DENKO C. W., BERGENSTAL D. M. The sicca syndrome (Sjogren's syndrome). A study of sixteen cases. Arch Intern Med. 1960 Jun;105:849–858. [PubMed] [Google Scholar]
  14. Doniach D. The concept of an 'autoallergic' hepatitis. Proc R Soc Med. 1970 May;63(5):527–531. [PMC free article] [PubMed] [Google Scholar]
  15. Fingerman D. L., Andrus F. C. Visceral Lesions Associated with Rheumatoid Arthritis. Ann Rheum Dis. 1943 May;3(3):168–181. doi: 10.1136/ard.3.3.168. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Frank O., Klemmayer K. Die alkalische Serumphosphatase bei Erkrankungen des rheumatischen Formenkreises und ihre Beeinflussung durch Kortikosteroide. Z Rheumaforsch. 1968 Apr;27(3):142–149. [PubMed] [Google Scholar]
  17. GOOD R. A., VENTERS H., PAGE A. R., GOOD T. A. Diffuse connective tissue disease in childhood with a special comment on connective tissue diseases in patients with agammaglobulinemia. J Lancet. 1961 May;81:192–204. [PubMed] [Google Scholar]
  18. Golding P. L., Bown R., Mason A. M., Taylor E. "Sicca complex" in liver disease. Br Med J. 1970 Nov 7;4(5731):340–342. doi: 10.1136/bmj.4.5731.340. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Goudie R. B., Macsween R. N., Goldberg D. M. Serological and histological diagnosis of primary biliary cirrhosis. J Clin Pathol. 1966 Nov;19(6):527–538. doi: 10.1136/jcp.19.6.527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Grausz H., Schmid R. Reciprocal relation between plasma albumin level and hepatic sulfobromophthalein removal. N Engl J Med. 1971 Jun 24;284(25):1403–1406. doi: 10.1056/NEJM197106242842504. [DOI] [PubMed] [Google Scholar]
  21. Johnson G. D., Holborow E. J., Glynn L. E. Antibody to smooth muscle in patients with liver disease. Lancet. 1965 Oct 30;2(7418):878–879. doi: 10.1016/s0140-6736(65)92505-5. [DOI] [PubMed] [Google Scholar]
  22. KALBAK K. Thymol reaction in rheumatoid arthritis. Ann Rheum Dis. 1951 Jun;10(2):182–185. doi: 10.1136/ard.10.2.182. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Karten I. Arteritis, myocardial infarction, and rheumatoid arthritis. JAMA. 1969 Dec 1;210(9):1717–1720. [PubMed] [Google Scholar]
  24. Kendall M. J., Bold A. M., Farr M., Hawkins C. F. 5-nucleotidase in the serum and synovial fluid of patients with rheumatoid disease. Lancet. 1971 Nov;2(7732):1012–1013. doi: 10.1016/s0140-6736(71)90327-8. [DOI] [PubMed] [Google Scholar]
  25. Kendall M. J., Cockel R., Becker J., Hawkins C. F. Rheumatoid liver? Br Med J. 1970 Jul 25;3(5716):221–221. doi: 10.1136/bmj.3.5716.221-a. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Kierat J. Ocena czynności watroby chorych na gościec przewlekły postepujacy leczonych solami złota. Reumatologia. 1973 Jan;11(1):11–17. [PubMed] [Google Scholar]
  27. Klatskin G., Kantor F. S. Mitochondrial antibody in primary biliary cirrhosis and other diseases. Ann Intern Med. 1972 Oct;77(4):533–541. doi: 10.7326/0003-4819-77-4-533. [DOI] [PubMed] [Google Scholar]
  28. LAINE V., HOLOPAINEN T., KOSKINEN H. M. Liver function tests in rheumatoid arthritis. Acta Rheumatol Scand. 1955;1(3):184–195. [PubMed] [Google Scholar]
  29. LEFKOVITS A. M., FARROW I. J. The liver in rheumatoid arthritis. Ann Rheum Dis. 1955 Jun;14(2):162–169. doi: 10.1136/ard.14.2.162. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. LEHMAN M. A., KREAM J., BROGNA D. ACID AND ALKALINE PHOSPHATASE ACTIVITY IN THE SERUM AND SYNOVIAL FLUID OF PATIENTS WITH ARTHRITIS. J Bone Joint Surg Am. 1964 Dec;46:1732–1738. [PubMed] [Google Scholar]
  31. Langness U. Die Bromsulphalein-Retintion als Index für die Aktivität der chronischen Polyarthritis. Z Rheumaforsch. 1969 Mar-Apr;28(3):152–159. [PubMed] [Google Scholar]
  32. Losada M., Prat G., Fernández L. Artritis reumatoidea asociada con polimiositis y esclerodermia con cirrosis hepatica. Caso anatomoclínico. Rev Med Chil. 1972;100(5):537–542. [PubMed] [Google Scholar]
  33. MALMQVIST E., REICHARD H. Serum ornithine carbamoyl transferase and transaminase activity in rheumatic disease. Acta Rheumatol Scand. 1962;8:170–182. doi: 10.3109/rhe1.1962.8.issue-1-4.18. [DOI] [PubMed] [Google Scholar]
  34. MOVITT E. R., DAVIS A. E. Liver biopsy in rheumatoid arthritis. Am J Med Sci. 1953 Nov;226(5):516–520. [PubMed] [Google Scholar]
  35. MacSween R. N., Goudie R. B., Anderson J. R., Armstrong E., Murray M. A., Mason D. K., Jasani M. K., Boyle J. A., Buchanan W. W., Williamson J. Occurrence of antibody to salivary duct epithelium in Sjogren's disease, rheumatoid arthritis, and other arthritides. A clinical and laboratory study. Ann Rheum Dis. 1967 Sep;26(5):402–411. doi: 10.1136/ard.26.5.402. [DOI] [PMC free article] [PubMed] [Google Scholar]
  36. NETTELBLADT E. Rheumatoid arthritis and hepatocellular injury. Acta Rheumatol Scand. 1960;6:256–266. doi: 10.3109/rhe1.1960.6.issue-1-4.27. [DOI] [PubMed] [Google Scholar]
  37. NETTELBLADT E. Rheumatoid arthritis and hepatocellular injury. Acta Rheumatol Scand. 1960;6:256–266. doi: 10.3109/rhe1.1960.6.issue-1-4.27. [DOI] [PubMed] [Google Scholar]
  38. Ozdemir A. I., Wright J. R., Calkins E. Influence of rheumatoid arthritis on amyloidosis of aging. Comparison of 47 rheumatoid patients with 47 controls matched for age and sex. N Engl J Med. 1971 Sep 2;285(10):534–538. doi: 10.1056/NEJM197109022851002. [DOI] [PubMed] [Google Scholar]
  39. Pettersson T., Wegelius O., Skrifvars B. Gastro-intestinal disturbances in patients with severe rheumatoid arthritis. Acta Med Scand. 1970 Jul-Aug;1-2(1):139–144. [PubMed] [Google Scholar]
  40. ROPES M. W., BENNETT G. A., COBB S., JACOX R., JESSAR R. A. 1958 Revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis. 1958 Dec;9(4):175–176. [PubMed] [Google Scholar]
  41. ROY L. M., WIGZELL F. W., DEMERS R., SINCLAIR R. J., DUTHIE J. J., ATHERDEN S. M., MARRIAN G. F. Liver function in relation to possible abnormalities of steroid metabolism in rheumatoid arthritis. Ann Rheum Dis. 1955 Jun;14(2):183–190. doi: 10.1136/ard.14.2.183. [DOI] [PMC free article] [PubMed] [Google Scholar]
  42. Rau R., Kühn H. A. Die Leber bei der progredient-chronischen Polyarthritis. Schweiz Med Wochenschr. 1972 May 6;102(18):635–640. [PubMed] [Google Scholar]
  43. Ritchie D. M., Boyle J. A., McInnes J. M., Jasani M. K., Dalakos T. G., Grieveson P., Buchanan W. W. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med. 1968 Jul;37(147):393–406. [PubMed] [Google Scholar]
  44. Russell A. S., Sturge R. A., Smith M. A. Serum transaminases during salicylate therapy. Br Med J. 1971 May 22;2(5759):428–429. doi: 10.1136/bmj.2.5759.428. [DOI] [PMC free article] [PubMed] [Google Scholar]
  45. SCHAEFER R. [Liver biopsy and liver autopsy findings in primary chronic polyarthritis]. Schweiz Med Wochenschr. 1962 Jun 23;92:777–781. [PubMed] [Google Scholar]
  46. SIEVERS K., JULKUNEN H., RUUTSALO H. M., HURRI L. LIVER FUNCTION IN RHEUMATOID ARTHRITIS. Ann Med Intern Fenn. 1964;53:53–60. [PubMed] [Google Scholar]
  47. Schaller J., Beckwith B., Wedgwood R. J. Hepatic involvement in juvenile rheumatoid arthritis. J Pediatr. 1970 Aug;77(2):203–210. doi: 10.1016/s0022-3476(70)80324-9. [DOI] [PubMed] [Google Scholar]
  48. TAUBNER A. BERICHT UBER 100 LEBERBIOPSIEN BEI PRIMAR CHRONISCHER POLYARTHRITIS. Z Rheumaforsch. 1963 Dec;22:443–451. [PubMed] [Google Scholar]
  49. VANSELOW N. A., DODSON V. N., ANGELL D. C., DUFF I. F. A clinical study of Sjogren's syndrome. Ann Intern Med. 1963 Jan;58:124–135. doi: 10.7326/0003-4819-58-1-124. [DOI] [PubMed] [Google Scholar]
  50. Walker J. G., Doniach D., Doniach I. Mitochondrial antibodies and subclinical liver disease. Q J Med. 1970 Jan;39(153):31–48. [PubMed] [Google Scholar]
  51. Whaley K., Goudie R. B., Williamson J., Nuki G., Dick W. C., Buchanan W. W. Liver disease in Sjögren's syndrome and rheumatoid arthritis. Lancet. 1970 Apr 25;1(7652):861–863. doi: 10.1016/s0140-6736(70)91690-9. [DOI] [PubMed] [Google Scholar]
  52. Whaley K., Webb J., McAvoy B. A., Hughes G. R., Lee P., MacSween R. N., Buchanan W. W. Sjogren's syndrome. 2. Clinical associations and immunological phenomena. Q J Med. 1973 Jul;42(167):513–548. [PubMed] [Google Scholar]
  53. Whaley K., Williamson J., Chisholm D. M., Webb J., Mason D. K., Buchanan W. W. Sjogren's syndrome. I. Sicca components. Q J Med. 1973 Apr;42(166):279–304. [PubMed] [Google Scholar]
  54. Whitehouse J. M., Holborow E. J. Smooth muscle antibody in malignant disease. Br Med J. 1971 Nov 27;4(5786):511–513. doi: 10.1136/bmj.4.5786.511. [DOI] [PMC free article] [PubMed] [Google Scholar]
  55. Zawadzki Z., Edwards G. A. Dysimmunoglobulinemia associated with hepatobiliary disorders. Am J Med. 1970 Feb;48(2):196–202. doi: 10.1016/0002-9343(70)90115-4. [DOI] [PubMed] [Google Scholar]

Articles from Annals of the Rheumatic Diseases are provided here courtesy of BMJ Publishing Group

RESOURCES