ABSTRACT
Gastrointestinal [GI] and hepatic manifestations are not uncommon in patients with systemic lupus erythematosus [SLE]. They include nonspecific symptoms as well as serious, life-threatening complications necessitating urgent, aggressive therapy. In addition to direct involvement of the GI system by the disease, many drug-induced side effects and opportunistic infections have GI and hepatic manifestations in these patients. Moreover, autopsy studies indicate a high prevalence of subclinical GI involvement in lupus patients. In this manuscript, the more clinically significant gastrointestinal and hepatic complications are reviewed
ABSTRACT
Non-alcoholic fatty liver disease/steatohepatitis [NAFLD/NASH] is the most common form of chronic liver disease woldwide and is no longer considered a benign disease. Its prevalence has not been determined in a large-scale population-based study in Iran. A total of 6583 individuals aged 18 to 65 were randomly selected from three geographically distinct provinces in Iran. Blood samples were obtained from each subject and a questionnaire was completed exploring data including self-admitted regular alcohol use. Serums were tested for anti-HCV antibody [anti-HCV], hepatitis B surface antigen and anti-hepatitis B core antibody. Positive samples for anti-HCV antibody were re-tested and those positive in a repeat ELISA were confirmed by a recombinant immunoblot assay [RIBA] test. Serums were also tested for ALT levels. Subjects with elevated ALT defined as serum ALT >/= 40 IU/L with no history of alcohol consumption and negative HBV and HCV infection were considered as [presumed NASH]. In this study 5589 subjects were analyzed. Two hundred and forty two individuals [4.3%] were diagnosed with elevated ALT levels. Among individuals with elevated ALT, 15 [6.2%] were diagnosed with either hepatitis B or hepatitis C. The overall weighted prevalence of presumed NASH was 2.9%. According to multivariate analysis, male sex, urban lifestyle, and being overweight or obese were significantly associated with [presumed NASH]. Obesity and metabolic syndrome, the most predictive factors of fatty liver disease, are increasing in Iran, therefore the prevalence of NAFLD/NASH and related complications are expected to increase in the future. This population based study gives a crude estimate of the prevalence of NASH around the country. Studies with more accurate surrogates of NASH need to be done. The disparity among different provinces merits special consideration