Liver disease is rarely present in systemic lupus erythematosus (SLE). Nevertheless, a recent retrospective study has found a broad spectrum of hepatic pathology in patients with SLE. It is, however, open to question whether this association is fortuitous, or whether any particular form of liver disease represents a manifestation of SLE. The following observation may provide an answer. In a patient granulomatous hepatitis appeared and subsided simultaneously with an exacerbation of SLE. This time course suggests that granulomatous hepatitis may represent a manifestation of SLE.