Congestive hepatopathy and acute pancreatitis as severe complications of mixed connective tissue disease

Clin J Gastroenterol. 2020 Jun;13(3):434-442. doi: 10.1007/s12328-019-01059-6. Epub 2019 Nov 19.

Abstract

Mixed connective tissue disease (MCTD) causes multiple organ dysfunctions, such as joint swelling, pulmonary fibrosis and hypertension, and serositis, but hepatopancreatic complications are rare. Here, we report a case of young man who exhibited acute severe liver dysfunction. He also had impaired cardiac function: both ventriculi were hypokinetic, but pulmonary hypertension and pericarditis were not observed. Since his liver and cardiac function markedly improved after commencing furosemide and carperitide, we considered congestive hepatopathy due to MCTD and accompanying heart failure. Heart failure and congestive hepatopathy recurred and he was treated with diuretics and prednisolone, but he passed away by co-occurrence of acute hemorrhagic pancreatitis. Necropsy revealed chronic hepatic congestion but not accompanying autoimmune hepatitis and hepatic vasculitis. We should consider congestive hepatopathy and hemorrhagic pancreatitis as serious complications of MCTD.

Keywords: Autoimmune hepatitis; Congestive hepatopathy; Heart failure; Mixed connective tissue disease; Pancreatitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Fatal Outcome
  • Heart Failure / etiology
  • Humans
  • Liver / pathology
  • Liver Diseases / diagnostic imaging
  • Liver Diseases / etiology*
  • Liver Diseases / pathology
  • Male
  • Mixed Connective Tissue Disease / complications*
  • Mixed Connective Tissue Disease / pathology
  • Pancreatitis / diagnostic imaging
  • Pancreatitis / etiology*
  • Skin / pathology
  • Tomography, X-Ray Computed