Clinical connection between rheumatoid arthritis and liver damage

Rheumatol Int. 2018 May;38(5):715-724. doi: 10.1007/s00296-018-4021-5. Epub 2018 Apr 7.


When liver damage is present in rheumatoid arthritis (RA) patients, it is sometimes difficult to determine whether it is a hepatic manifestation of RA, associated primary liver disease or hepatotoxic liver disease which developed during the treatment of RA. Liver damage during RA is most common in the form of asymptomatic abnormal liver tests. Occasionally, liver damage may progress to cirrhosis. Patients with RA are more susceptible to an associated autoimmune liver disease. Medications used in rheumatology are often hepatotoxic and it is difficult to differentiate between hepatic manifestations of the primary disease and potential hepatotoxicity of the administered medications. The significance of the paper is in the fact that it includes the most relevant and the latest information on this commonly present problem in clinical practice. The aim of the author is to provide comprehensive but at the same time concise data which will be useful to the doctors who come into contact with RA patients with symptomatic or asymptomatic liver disease. Timely diagnosis and treatment of liver disease in RA patients can significantly influence the course and outcome of rheumatoid arthritis.

Keywords: Arthritis; Biological therapy; Hepatitis; Liver; Rheumatoid.

Publication types

  • Review

MeSH terms

  • Antirheumatic Agents / adverse effects
  • Arthritis, Rheumatoid* / diagnosis
  • Arthritis, Rheumatoid* / drug therapy
  • Arthritis, Rheumatoid* / epidemiology
  • Arthritis, Rheumatoid* / immunology
  • Chemical and Drug Induced Liver Injury / diagnosis
  • Chemical and Drug Induced Liver Injury / epidemiology
  • Chemical and Drug Induced Liver Injury / immunology
  • Chemical and Drug Induced Liver Injury / therapy
  • Early Diagnosis
  • Humans
  • Liver Diseases* / diagnosis
  • Liver Diseases* / epidemiology
  • Liver Diseases* / immunology
  • Liver Diseases* / therapy
  • Liver Function Tests
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors


  • Antirheumatic Agents