Frequency and associated factors of hepatic hemangioma in systemic lupus erythematosus patients undergoing abdominal imaging: a retrospective cohort study.

Hepatic hemangioma may be detected in patients with systemic lupus erythematosus (SLE). This study aimed to determine the frequency, radiological characteristics, and potential associated factors of hepatic hemangioma in SLE patients undergoing abdominal imaging. We retrospectively evaluated 221 of 402 SLE patients followed at a tertiary university hospital who underwent abdominal imaging for clinical indications. Demographic, clinical, laboratory, and radiological data were collected from medical records. Factors associated with hepatic hemangioma were analyzed. A total of 221 SLE patients who underwent abdominal imaging were included. All patients underwent abdominal ultrasound as the primary imaging modality. The mean age was 49.62 ± 13.75 years, 86.4% were female, mean age at SLE diagnosis was 36.29 ± 14.48 years, and mean disease duration was 12.81 ± 8.14 years. The most common indication for abdominal imaging was asymptomatic/routine screening/pre-renal biopsy evaluation (n = 117, 53%). Hepatic hemangioma was detected in 11.8% (n = 26) of the imaged SLE patients. Among these, 69.2% were identified after SLE diagnosis, 27% concurrently, and 3.8% before diagnosis. Most hemangiomas were solitary (65.4%), with a mean diameter of 2.57 ± 2.22 cm. Patients with hepatic hemangioma had significantly longer disease duration (15.85 ± 7.82 vs. 12.40 ± 8.12 years; p = 0.043) and follow-up duration (15.38 ± 7.98 vs. 11.61 ± 7.89 years; p = 0.030) compared to those without. At SLE diagnosis, pleuritis (19.2% vs. 5.6%; p = 0.035), autoimmune hemolytic anemia (AIHA) (38.5% vs. 18.6%; p = 0.037), and C3 hypocomplementemia (80.8% vs. 55.4%; p = 0.014) were significantly more common in the hemangioma group. Multivariate logistic regression analysis revealed that longer SLE disease duration (OR 1.06 per year; 95% CI 1.01-1.12; p = 0.020) and presence of AIHA at diagnosis (OR 3.42; 95% CI 1.32-8.88; p = 0.011) were independently associated with hepatic hemangioma. Hepatic hemangiomas may be incidentally detected in SLE patients undergoing abdominal imaging. They were significantly more frequent in patients with longer disease duration and in those with AIHA at SLE diagnosis. However, these findings should be interpreted cautiously due to the retrospective design and selected nature of the study population. Prospective longitudinal studies with unselected SLE cohorts and appropriate control groups are needed to better define the true frequency and their associated factors of hepatic hemangiomas in SLE.