Autoimmune liver diseases and systemic rheumatic disorders: exploring their interplay and impact on prognosis

BMC Gastroenterol. 2025 Apr 22;25(1):282. doi: 10.1186/s12876-025-03852-9.

Abstract

Background: Autoimmune liver diseases (AILDs) are associated with systemic rheumatic diseases (SRDs) and their autoantibodies. This study investigates the prevalence of SRDs and related autoantibodies in AILD patients and their prognostic implications.

Methods: We retrospectively analyzed all AILD patients followed at Emek Medical Center's Hepatology Clinic for SRDs and their autoantibodies. Patients were divided into two groups: AILD with vs. without SRDs and AILD with vs. without autoantibodies. Clinical course, outcomes, and prognostic parameters were compared between these groups.

Results: Among 157 AILD patients, SRDs were present in 16.8%, and autoantibodies were detected in 40.8%. Patients with both AILD and SRDs exhibited significantly higher frequencies of anti-dsDNA (p = 0.005), anti-RNP (p < 0.001), APLA (p = 0.004), RF (p = 0.02), and anti-Ro (p = 0.001). Notably, AILD patients with autoantibodies had a higher rate of liver transplantation compared to those without (8% vs. 0%, p = 0.036). However, no significant differences in overall prognosis or outcomes were observed between AILD patients with and without SRDs.

Conclusions: SRDs and their associated autoantibodies are highly prevalent in AILD patients. The presence of specific autoantibodies, particularly anti-dsDNA, anti-RNP, APLA and anti-Ro may indicate an association with SRDs and could have prognostic value in AILD progression. Further studies are needed to validate these findings and explore their clinical implications.

Keywords: Autoantibodies; Autoimmune liver diseases; Liver transplantation; Prognosis; Systemic rheumatic diseases.

MeSH terms

  • Adult
  • Aged
  • Antibodies, Antinuclear / blood
  • Autoantibodies* / blood
  • Autoimmune Diseases* / complications
  • Autoimmune Diseases* / immunology
  • Female
  • Hepatitis, Autoimmune* / complications
  • Hepatitis, Autoimmune* / immunology
  • Humans
  • Liver Transplantation / statistics & numerical data
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Rheumatic Diseases* / complications
  • Rheumatic Diseases* / immunology

Substances

  • Autoantibodies
  • Antibodies, Antinuclear