How does sjogrens affect the liver

The prevalence of this association was found to be higher in our study than in other previous series [ 2 — 7 ]. The true prevalence could be even higher since liver enzyme profiles were not done in all patients. In , Tsianos and co-workers described 22 SS patients with gastrointestinal complications, called from a large cohort; only two patients had liver disease, each with chronic active hepatitis [ 4 ].

Other studies have reported variable prevalence [ 3 , 28 ] and different histopathological findings in liver biopsies ranging from cholestatic liver damage stage I primary biliary cirrhosis to chronic active hepatitis due to hepatitis C virus.

Those patients with serological evidence of systemic inflammation, as shown by an elevated sedimentation rate, were more likely to have liver test abnormalities. Also, the presence of a positive anti-ENA correlated positively with hepatic disease. An association of ENA response with liver disease has been described in children with autoimmune hepatitis, where anti-ENA-positive patients demonstrated more severe liver test abnormalities than those who were anti-ENA-negative [ 32 ].

Transgenic mice models that carry the HCV envelope genes develop an exocrinopathy affecting salivary and lachrymal glands [ 19 ]. Although the prevalence of viral hepatitis markers in our group of patients with liver disease was very low and did not account for most of the cases with abnormal liver function tests, these markers were not sought in a small percentage of these patients.

It is important to note that HCV appears to account for a subgroup of patients with exocrine complaints in which half the cases might meet the definition for SS according to European and Manthorpe criteria. In our review of cases, we found predominance in hepatocellular liver damage rather than cholestatic disease, which would argue against a PBC-type of liver damage. Other authors had proposed that SS associated with PBC should be considered a form of secondary SS that resembles more the "sicca complex" with exocrine features seen in patients with rheumatoid arthritis [ 40 , 41 ].

Limitations of the study come primarily from being a retrospective analysis. While we could not find an association between use of NSAIDS or other medications and prevalence of liver function tests abnormalities, the study design did not allow us to exclude the possibility of over-the-counter OTC medication use that could have affected LFT's measurement. Drug toxicity is certainly an important factor to be considered.

However, given that most patients had persistent rather than intermittent abnormalities of LFTs and that the use of hepatotoxic drugs was not elicited in the majority of patients with liver abnormalities, a toxic effect of medications could not be established.

Although no other diagnosis explaining liver disease may be found, the disorders for which treatment might be beneficial e. Christianson J: Corneal changes in a case of hepatitis.

Acta Ophtalmol. Article Google Scholar. Br J Rheumatol. Scand J Rheumatol. CAS Google Scholar. J Hepatol. Nippon Rinsho. Prospective study using biochemical and serological markers of hepatic dysfunction. Ann Rheum Dis. Acta Med Scand. Archimandritis A, Tjivras M, Tsirantonaki M, Hatzis G, Delladetsima I: Sjogren's syndrome with antimitochondrial antibody-negative primary biliary cirrhosis: a case of autoimmune cholangitis. J Clin Gastroenterol. Ann Intern Med.

Review of extrahepatic manifestations. Scand J Gastroenterol. Arthritis Rheum. Presse Medicale. Ter Arkh. Am J Surg. J Rheumatol. Czaja AJ: The variant forms of autoimmune hepatitis. Arthr Rheum. Vitali C, Bombardieri S: The diagnosis of Sjogren's syndrome: definition and validation of classification criteria for this disorder.

Ann Med Interne Paris. J Oral Surg. Arch Intern Med. Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Overview Sjogren's SHOW-grins syndrome is a disorder of your immune system identified by its two most common symptoms — dry eyes and a dry mouth. Salivary glands Open pop-up dialog box Close. Salivary glands You have three pairs of major salivary glands — parotid, sublingual and submandibular.

Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Sjogren's syndrome. Your doctor may also order blood tests, X-ray, salivary gland biopsy, tests for tear production, eye exams, and tests for saliva production. Your doctor will tailor your treatment plan to help relieve symptoms.

Your doctor may recommend medications or treatments to improve lubrication of the eye and mouth. Your doctor may also recommend using artificial tears and eye drops, increasing your fluid intake, using moisturizers, stopping smoking, increasing humidity, and saline nasal sprays.