Open AccessHepatobiliary system diseases as the predictors of psoriasis progression
Author(s) -
С. В. Смирнова,
А. А. Барило,
M. V. Smolnikova
Publication year - 2016
Publication title -
vestnik rossijskoj akademii medicinskih nauk
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.122
H-Index - 15
eISSN - 2414-3545
pISSN - 0869-6047
DOI - 10.15690/vramn636
Subject(s) - medicine , psoriatic arthritis , psoriasis , gastroenterology , primary biliary cirrhosis , alcoholic hepatitis , fatty liver , liver disease , cirrhosis , pathology , disease , alcoholic liver disease , immunology
Purpose of the study. To assess the state of the hepatobiliary system in psoriasis and psoriatic arthritis in order to establish a causal relationship and to identify clinical and functional predictors of psoriatic disease progression.Methods. The study included patients with extensive psoriasis vulgaris (n = 175) from the age of 18 to 66. Divided into 3 groups: 1 – psoriasis patients with isolated skin lesions (n = 77), 2 – patients with psoriatic arthritis (n = 98), 3 – apparently healthy blood donors (n = 30), matched by sex and age. The evaluation of functional state of the hepatobiliary system was performed by analysis of the clinical and anamnestic data and by the laboratory- instrumental methods.Results. Identified predictors psoriasis: triggers (stress and nutritional factor), increased total bilirubin, aspartate aminotransferase, alkaline phosphatase, gamma glutamyl transferase, eosinophilia, giardiasis, carriers of hepatitis C virus, and changes focal ductal formation in the liver , thickening of the walls of the gallbladder by ultrasound. Predictors of psoriatic arthritis: age over 50 years, dyspeptic complaints, the presence of hepatobiliary system diseases, the positive right hypochondrium syndrome, the clinical symptoms of chronic cholecystitis, excess body weight, high levels of bilirubin, cholesterol and low density lipoprotein, hepatomegaly, non-alcoholic fatty liver disease.Conclusion. High activity of hepatocytes cytolysis, cholestasis, inflammation, metabolic disorders can be considered psoriatic arthritis as a severe clinical stage psoriatic disease where the hepatobiliary system, in turn, is one of the main target organs in systemic psoriatic process. Non-alcoholic fatty liver disease and chronic cholecystitis are predictors of psoriatic disease progression.