by Elana Gotkine

Liver function tests can ID occult disorders in systemic sclerosis

Liver function test (LFT) screening can identify occult hepatitis, cholestasis, and cholestatic hepatitis in patients with systemic sclerosis (SSc), according to a study published online May 2 in Open Access Rheumatology: Research and Reviews.

Kookwan Sawadpanich, from Khon Kaen University in Thailand, and colleagues conducted a historical cohort study involving 674 SSc patients who underwent routine screening for LFT. Clinical predictors of abnormal LFT were analyzed using Cox regression.

The researchers found that 430 cases, representing 4,190 person-years, had abnormal LFTs (incidence rate, 10.2 per 100 person-years). The incidence of hepatitis, cholestasis, and cholestatic hepatitis was 20.5, 12.9, and 20.4 per 100 person-years, respectively. The median first-time detection was 3.0, 5.9, and 2.8 years for hepatitis, cholestasis, and cholestatic hepatitis, respectively; none had signs or symptoms indicative of liver disease.

Predictors of an abnormal LFT in SSc were elderly SSc onset, alcoholic drinking, and a high modified Rodnan Skin Score (hazard ratios, 1.02, 1.74, and 1.03, respectively), edematous skin, Raynaud phenomenon, and hyperCKaemia (hazard ratios, 2.94, 1.39, and 1.88, respectively), and methotrexate use (hazard ratio, 1.55). Protective factors included current sildenafil treatment and high serum albumin (hazard ratios, 0.63 and 0.70, respectively).

"By LFT screening, occult hepatitis, cholestasis, and cholestatic hepatitis can be detected in patients with SSc," the authors write. "Elderly age at onset, alcohol consumption, extensive skin tightness, active organs, and immunosuppressive use were predictors of abnormal LFT."

More information: Kookwan Sawadpanich et al, Incidence and Predictors of an Abnormal Liver Function Test Among 674 Systemic Sclerosis Patients: A Cohort Study, Open Access Rheumatology: Research and Reviews (2023). DOI: 10.2147/OARRR.S410165

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