Liver involvement in Sjögren’s syndrome (SS) is commonly subclinical and almost never appears as the first manifestation of the disease. The prevalence of liver involvement in SS varies among series and depends on the diagnostic criteria used. Studies conducted in the 1960s, based on clinical (i.e., liver enlargement) and serological (i.e., elevated alkaline phosphatase) findings estimated the SS liver involvement as high as 20% . A somewhat lower prevalence of liver disease has been reported in more recent studies, with estimates ranging from 2% to 20% of SS patients [2–6].
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