The correlation between rheumatic diseases and liver diseases is complex and often not given sufficient attention. There are, however, consequences for diagnosis and therapy. Rheumatic diseases can present with hepatic symptoms while liver diseases can exhibit rheumatic symptoms. Examples of liver diseases as a cause of rheumatic symptoms are viral hepatitis B and C, autoimmune hepatitis and hemochromatosis. As a result of rheumatic diseases, such as adult onset Still's disease and systemic lupus erythematosus, liver dysfunction can occur. Autoimmune hepatitis, primary biliary cirrhosis and primary sclerosing cholangitis are directly associated with rheumatic diseases and have to be distinguished by way of differential diagnosis. During antirheumatic therapy, serious hepatotoxic side effects have to be expected.
