నైరూప్య

Fatal case of cirrhosis with systemic lupus erythematosus: A case report.

Sheeral Sajjad, Shantanu Sawale, Shilpa Bawankule*

Systemic lupus erythematosus is a rare multisystem autoimmune disorder in which there is production of autoantibodies, which cause damage to the host body. The most commonly involved are the renal and cardiovascular systems, and the liver is rarely affected and initially manifests as abnormal Liver function tests. The cause for liver involvement can be lupus itself which presents as lupus hepatitis, autoimmune hepatitis or due to some drug treatment the patient could have undergone in the past. The diagnosis of autoimmune hepatitis includes clinical and laboratory findings which are characteristic to this disorder, abnormal serum globulin levels, histologic abnormalities and whether one or more characteristic autoantibodies are present. Unlike AIH diagnosis of lupus hepatitis is based on that of exclusion and appropriate treatment should be immediately prompted. Lupus hepatitis shows response with corticosteroid therapy usually lupus hepatitis responds well to treatment. Drugs such as prednisone and hydroxychloroquine show good response in SLE. Diagnosing liver disease in SLE is a cumbersome task Here we report a rare case of a 56-year-old female patient who was a known case of systemic lupus erythematosus and cirrhosis. She presented in the outpatient department with altered sensorium, generalised weakness, and loss of appetite, bilateral pedal edema and icterus. She was a diagnosed case of SLE since 5 years and cirrhosis of liver which was done 2 years ago. She had stopped using the SLE drugs prescribed to her since a year and was managed for her recent admission with antibiotics, antiemetics, antacids, beta blockers, laxatives and globulin.