Systemic Lupus Erythematosus (SLE) is a complex autoimmune disease
characterized by autoantibodies against the cell nucleus and involves many organ
systems in the body with unknown etiologies and various clinical manifestations,
disease course and prognosis. SLE can be found at all ages, generally appearing at
age 9-58 years with a peak at age 28 years. It is more common in women with a ratio
of women to men 15: 1 to 22: 1. The highest incidence and prevalence of SLE was
found in North America 23.2 / 100.000 population / year and 241 / 100.0000
population. In Indonesia, there has been an increase in visits to SLE patients from
17.9-27.2% in 2015 to 30.3-58% in 2017. One of the manifestations of SLE is
hepatitis lupus, which is inflammation of the liver tissue. Lupus hepatitis can occur
in 20-50% of patients with SLE. It was reported that a 20-year-old man presented
with complaints of pain in the joints of the right and left hands which increased since
1 week. The patient also complained of reddish patches on the face, hair loss and
mouth sores. Physical examination revealed anemic eye conjunctiva, malar rash,
oral ulcer. During the joint examination, there was tenderness in bilateral MCP and
PIP. The abdominal examination revealed hepatomegaly. Investigations revealed
anemia, thrombocytopenia, increased liver function. Abdominal ultrasound revealed
hepatomegaly. ANA profile examination was positive for anti RNP, anti -sm, and anti -
ribosomal protein antibodies. The patient was diagnosed with Systemic Lupus
Erythematosus with lupus hepatitis according to the ACR (American College of
Rheumatology) criteria in which the patient had 6 criteria. The patient was given
therapy with 2x125 mg of intravenous methyl prednisolone for 3 days and
hydroxychloroquine 1x200 mg orally and other symptomatic drugs.