- Primary hepatic sarcoidosis presenting with cholestatic liver disease and mimicking primary biliary cholangitis: a case report
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Young Joo Park, Hyun Young Woo, Moon Bum Kim, Jihyun Ahn, Jeong Heo
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J Yeungnam Med Sci. 2022;39(3):256-261. Published online August 10, 2021
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DOI: https://doi.org/10.12701/yujm.2021.01151
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- Sarcoidosis often involves the liver. However, primary hepatic sarcoidosis confined to the liver without evidence of systemic involvement is rare. We report the case of a 37-year-old man with hepatic sarcoidosis who initially presented with elevated liver enzymes and suspicious cirrhotic nodules on computed tomography. The patient had cirrhosis but did not have portal hypertension. Based on the initial histopathologic finding of chronic granulomatous inflammation and the common clinical characteristics of sarcoidosis, he was initially diagnosed with primary biliary cholangitis, and his daily dosage of ursodeoxycholic acid was increased to 900 mg. After 14 months of treatment, his total serum bilirubin concentration was 10.9 mg/dL (upper normal limit, 1.2 mg/dL). Additionally, a transjugular liver biopsy revealed multiple noncaseating granulomas. He was diagnosed with primary hepatic sarcoidosis involving the lungs, heart, spleen, kidneys, and skin. Treatment with methylprednisolone was initiated. Two weeks later, he was started on azathioprine, and the dose of steroid was simultaneously reduced. These findings indicate the importance of including hepatic sarcoidosis as a possible diagnosis in patients with elevated liver enzymes or cryptogenic cirrhosis.
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Citations
Citations to this article as recorded by  - Liver biopsy as a useful diagnostic tool for hepatic sarcoidosis: A case report
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Medicine International.2024;[Epub] CrossRef - Navigating Challenges in a Case of Unusual Hepatic and Pulmonar Sarcoidosis: A Comprehensive Clinical Journey
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GE - Portuguese Journal of Gastroenterology.2024; : 1. CrossRef - The clinical management of hepatic sarcoidosis: A systematic review
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