Liver and rheumatism

There are multiple relations between rheumatic diseases and the liver, nevertheless the liver is extremely rare involved in rheumatic diseases. "Elevated liver enzymes" are quite often found in patients who are under the medication with immunsuppressive drugs or/and non-steroidal antirheumatics. The most frequent cause for "elevated liver enzymes" are toxic and allergic side effects of drugs; however, in rare cases it might be extremly helpful to examine, whether an independent liver disease exists. Underlying liver diseases which might be associated with the rheumatic disorder or exist accidentially may change the therapeutic management of the patient. If the liver disease present can cause the rheumatic disorder (e.g. virus-induced vasculitis, hemochromatosis), a specific hepatological therapy should precede the immunsuppression.