Rheumatologic manifestations of hepatic diseases

Authors Bruno Fernandes, Emanuel Dias, Miguel Mascarenhas-Saraiva, Miguel Bernardes, Lúcia Costa, Hélder Cardoso, Guilherme Macedo.


The course of hepatic diseases may be complicated by a multitude of rheumatologic manifestations, which can complicate the diagnostic approach and alter the natural history of primary liver disease, sometimes worsening prognosis due to associated multiple organ dysfunction. These manifestations can occur in association with a multitude of liver diseases, including viral hepatitis, autoimmune hepatitis, alcoholic liver disease, nonalcoholic fatty liver disease, hemochromatosis, or Wilson’s disease. It is necessary not only for rheumatologists, but also for other clinicians, to be aware that these atypical manifestations may reflect an undiagnosed hepatic disease. On the other hand, it is crucial that, in a patient with known hepatic disease presenting with rheumatologic symptoms, an accurate distinction be made between the rheumatologic manifestations of hepatic disease and primary rheumatologic disease, since the treatment is often different. This review aims to summarize the current evidence regarding rheumatologic manifestations of hepatic diseases, how to distinguish them from primary rheumatologic disorders, and how to provide adequate management.

Keywords Rheumatologic manifestations, arthritis, hepatic diseases, hepatitis

Ann Gastroenterol 2019; 32 (4): 352-360

Review Articles