Background: Liver involvement is not considered a typical extra-articular manifestation
and has rarely been studied in rheumatoid arthritis (RA).
We aimed to identify the prevalence and aetiologies of liver disease in RA patients.
Methods: A cross-sectional study included 150 patients with RA enrolled over 5 years (2010-
2015). The clinical and paraclinical features of RA were analyzed. The clinical and biological characteristics
of liver impairment and its aetiologies were collected.
Results: One hundred and fifty RA patients (124 women) with a mean age of 57.09 years and a
mean RA duration of 7.52 years were included. Liver involvement was diagnosed in 66 patients
(44%). The liver disease was asymptomatic in 94% of the cases, revealed by increased gammaglutamyl
transferase levels in 74% of the patients. The aetiologies of liver involvement were hepatotoxicity
of medications in 38 cases (57%), hepatitis B and C in 14 patients (21%), fatty liver disease
in 10 cases (15%), autoimmune liver disease in 2 patients (3%), hydatid cyst in 1 case (2%),
and liver angiomas in 1 case (2%). Non-steroidal anti-inflammatory drugs and methotrexate were
the drugs most often involved in the genesis of hepatotoxicity (21% and 20% of the cases, respectively).
Conclusion: Liver involvement occurred in 44% of RA patients. Aetiologies were mainly hepatotoxicity
and viral hepatitis B and C. Patients with RA should be systematically screened for liver
disease, which is rarely symptomatic.