# Clinical Characterization of Autoimmune Hepatic Involvement in Sjogren’s Disease: A Retrospective Cohort Study in Korea

## TL;DR

This study identifies clinical features and risk factors for autoimmune liver disease in patients with Sjogren’s disease in Korea.

## Contribution

The study provides new insights into the prevalence and clinical associations of autoimmune hepatic involvement in Sjogren’s disease.

## Key findings

- Autoimmune hepatitis (AIH) was the most common type of hepatic involvement in Sjogren’s disease patients.
- Splenomegaly, elevated antinuclear antibody titer, and ACA positivity were independently associated with liver involvement.
- Most patients with hepatic involvement responded well to immunosuppressive therapy.

## Abstract

Sjogren’s disease (SjD) is a systemic autoimmune disease primarily affecting the exocrine glands. Systemic manifestations, including hepatic involvement, are increasingly recognized. This study aimed to delineate the clinical features and associated factors of autoimmune hepatic involvement in SjD. A retrospective analysis was conducted on patients diagnosed with SjD at Seoul St. Mary’s Hospital over the past 10 years. Autoimmune hepatic involvement was defined by fulfilling diagnostic criteria for autoimmune hepatitis (AIH) or primary biliary cholangitis (PBC). Clinical, serological, and demographic data were obtained from medical records. Among 1119 patients with SjD, 51 (4.6%) had autoimmune hepatic involvement. AIH (64.7%) was the most common type, followed by PBC (27.5%) and overlapping disease (7.8%). Compared to those without hepatic involvement, affected patients were older at diagnosis (p = 0.003) and showed higher frequencies of thrombocytopenia, splenomegaly, anti-centromere antibody (ACA), and elevated antinuclear antibody titers as measured by indirect immunofluorescence (IFI-HEp-2) (all p < 0.001). Multivariable analysis identified splenomegaly, elevated IFI-HEp-2 titer, and ACA positivity as independent factors associated with hepatic involvement. Most patients responded well to immunosuppressive therapy, with only a small proportion (15.7%) progressing to liver fibrosis. Autoimmune hepatic involvement is relatively uncommon but clinically meaningful in patients with SjD.