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Komorbidität rheumatischer und hepatologischer Erkrankungen

Comorbidity of rheumatic and hepatic diseases

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Zusammenfassung

Die Wechselbeziehung zwischen rheumatischen Erkrankungen und Lebererkrankungen ist vielschichtig und wird oft zu wenig beachtet. Es ergeben sich jedoch Konsequenzen für die Diagnostik und Therapie. Rheumaerkrankungen können sich mit hepatischen Symptomen präsentieren, während Erkrankungen der Leber rheumatische Symptome aufweisen können. Beispiele für Lebererkrankungen als Ursache rheumatischer Symptome sind die Virushepatitiden B und C, die autoimmune Hepatitis und die Hämochromatose. Als Folge rheumatischer Erkrankungen wie dem adulten M. Still und dem systemischen Lupus erythematodes können Leberfunktionsstörungen auftreten. Die autoimmune Hepatitis, die primär biliäre Zirrhose und die primär sklerosierende Cholangitis sind direkt mit rheumatischen Erkrankungen assoziiert und müssen differenzialdiagnostisch abgegrenzt werden. Im Rahmen der antirheumatischen Therapie muss mit ernsten hepatotoxischen Nebenwirkungen gerechnet werden.

Abstract

The correlation between rheumatic diseases and liver diseases is complex and often not given sufficient attention. There are, however, consequences for diagnosis and therapy. Rheumatic diseases can present with hepatic symptoms while liver diseases can exhibit rheumatic symptoms. Examples of liver diseases as a cause of rheumatic symptoms are viral hepatitis B and C, autoimmune hepatitis and hemochromatosis. As a result of rheumatic diseases, such as adult onset Still’s disease and systemic lupus erythematosus, liver dysfunction can occur. Autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis are directly associated with rheumatic diseases and have to be distinguished by way of differential diagnosis. During antirheumatic therapy, serious hepatotoxic side effects have to be expected.

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Einhaltung der ethischen Richtlinien

Interessenkonflikt. W.-J. Mayet und A.W. Lohse geben an, dass kein Interessenkonflikt besteht. Alle angewandten Verfahren stehen im Einklang mit den ethischen Normen der verantwortlichen Kommission für Forschung am Menschen (institutionell und national) und mit der Deklaration von Helsinki von 1975 in der revidierten Fassung von 2008. Alle Patienten wurden erst nach erfolgter Aufklärung und Einwilligung in die Studie eingeschlossen. Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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Authors and Affiliations

  1. Zentrum für Innere Medizin , Nordwest Krankenhaus Sanderbusch, Hauptstr., 26452, Sande, Deutschland

    W.-J. Mayet

  2. I. Medizinische Klinik und Poliklinik, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland

    A.W. Lohse

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  1. W.-J. Mayet
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Correspondence to W.-J. Mayet or A.W. Lohse.

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Mayet, WJ., Lohse, A. Komorbidität rheumatischer und hepatologischer Erkrankungen. Z. Rheumatol. 72, 547–554 (2013). https://doi.org/10.1007/s00393-012-1116-3

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