Corticosteroids and Cholelithiasis in Systemic Lupus Erythematosus
The aim. To evaluate the frequency of gallstone formation and alteration of plasma lipid profiles in SLE patients long treated with prednisolone. Material and methods. Sixty patients with SLE were divided into 2 groups: (1) 38 SLE patients without gallstones; (2) 22 SLE patients with gallstones. Gallbladder ultrasonography was performed in all the patients, and the serum lipid profile was determined. To identify the composition and structure of gallstones obtained during cholecystectomy, color cathodoluminescence scanning electromicroscopy was used. Results. Gallstone disease was detected in 22 (36.7%) patients of the 60 examinees and in 22 (68.8%) of the 32 SLE patients receiving prednisolone therapy; whereas none of the 28 prednisolone-untreated patients was found to have the disease (). There were the most significant differences between the SLE patients with and without gallstones in the duration of administration of prednisolone and in its mean daily and mean monthly doses, and cumulative ones. Conclusion. Age at the onset of the disease, the mean daily dose of corticosteroids, and the duration of therapy with these agents are the most likely factors predisposing to gallstone disease in SLE patients. The CCL-SEM study identified predominantly the protein-cholesterol structure of gallstones.
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