[Obstructive jaundice caused by granulomatous stenosis of the extrahepatic bile ducts in sarcoidosis] (original) (raw)
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Extrahepatic Biliary Obstruction: An Unusual Presentation of Hepatic Sarcoidosis
Clinical Medicine Insights: Gastroenterology, 2015
We report this case of a 63-year-old woman who presented with progressive illness characterized by abdominal pain, weight loss, anorexia, generalized weakness, and fatigue. The patient was found to have obstructive jaundice with multiple mass lesions in the liver, spleen, and kidney on computed tomography scan of abdomen. She developed cholangitis, necessitating an emergent endoscopic retrograde cholangiopancreatography with biliary stenting and decompression. Later, she was found to have hepatic sarcoidosis on wedge biopsy of the liver. Extrinsic compression of biliary tree from mass effect of sarcoid granulomas with superimposed biliary sepsis is rare.
Hepatic Sarcoidosis- an Unusual Cause of Jaundice: a Case Report
Research Square (Research Square), 2024
Introduction: Sarcoidosis is a chronic disorder. Its hallmark is the presence of noncaseating granuloma. Most cases are asymptomatic. However, few of them progress to liver cirrhosis and liver failure. Treatment of hepatic sarcoidosis is challenging as there is no large randomized controlled till date has been done to evaluate the e cacy of drugs. The Unique characteristic of this case report is that Sarcoidosis may present with jaundice and need to be borne in mind when a patient presenting with jaundice and no usual cause failed to be identify any usual cause. Despite having sarcoidosis, the patient did not have any respiratory symptom. Case presentation: We are presenting a case of hepatic sarcoidosis who presented with abdominal pain, fever and jaundice. After excluding of all common causes of jaundice, hepatic sarcoidosis was diagnosed with liver biopsy. Conclusion: High levels of suspicion is needed to diagnose hepatic sarcoidosis as this is an unusual cause of jaundice. Although rare, hepatic sarcoidosis can be treated with steroids. The prime takeaway message from this case report is to consider Sarcoidosis as an unusual but treatable cause of jaundice when the conventional causes are failed to be the cause of jaundice.
Primary biliary cirrhosis and hepatic sarcoidosis--a case report
Vojnosanitetski pregled. Military-medical and pharmaceutical review, 2014
Primary biliary cirrhosis (PBC) is an immune-mediated chronic progressive inflammatory liver disease leading to destruction of small interlobular bile ducts. Sarcoidosis is a chronic disorder of unknown etiology characterized by non-caseous granulomas. We reported a 69-year-old female patient with abdominal pain, malaise, vertigo, headaches, hands tremor and partial loss of hearing. Initial laboratory findings revealed elevated liver function tests and cholesterol with positive antimytochondrial and antinuclear antibodies. Liver biopsy revealed granuloma typical for PBC and granulomatous lesions typical for sarcoidosis. Elevated serum angiotensin-converting enzyme and granulomatous lesion on the brain magnetic resonance imaging (MRI) were detected and the patient was diagnosed with overlap of PBC and liver sarcoidosis and neurosarcoidosis. The patient was treated with ursodeoxicholic acid (UDCA) and prednisolone. Six months later the patient was symptom-free with laboratory findings...
Vojnosanitetski pregled, 2014
Introduction. Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Although hepatic granulomas occur in 50-65% of patients with systemic sarcoidosis, isolated liver sarcoidosis is rare. Clinical presentation varies from asymptomatic to manifest. The diagnosis is based on a characteristic histopathological finding of liver biopsy. Case report. We reported a 69-year old man was admitted due to abdominal swelling and abdominal pain. Laboratory studies detected: cholestasis, pancytopenia and elevaton of angiotensin-converting enzyme. Abdominal imaging techniques showed liver cirrhosis, splenomegaly and ascites. The diagnosis of the hepatic sarcoidosis was confirmed by histopathological examination of liver biopsy. The patient was treated with corticosteroids. After 18 months the patient was without any subjective symptoms, and with biochemical and clinical improvement. Conclusion. Isolated hepatic sarcoidosis should be considered in the differential diagnosis of asymp...
Tomography
Sarcoidosis is a multisystem disease usually affecting the chest, hilar lymph nodes, and lungs, but can potentially involve any organ; therefore, its clinical presentation may vary. Hepatobiliary involvement is rare, and typically asymptomatic; however, it can lead to cirrhosis, and may require liver transplantation. In this report, we present a rare case of a patient affected by sarcoidosis with hepatobiliary involvement. He presented to our hospital complaining of dyspnea triggered by moderate efforts and oppressive thoracic discomfort. Chest X-ray showed multiple bilateral nodular opacities and enlargement of both hilar regions, confirmed by a subsequent total-body computed tomography scan and positron emission tomography, which also revealed cardiac, splenic, and hepatic involvement. Liver function was studied via gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging, and magnetic resonance cholangiopancreatography (MRCP) w...
Hepatic Involvement in Systemic Sarcoidosis
Objective: Rare disease Background: Sarcoidosis is a systemic disease that can affect any organ, including the liver. It is manifested by the presence of non-caseating granulomas within involved organs, most commonly the pulmonary, lymphatic, and hepatic system. Unlike pulmonary or lymphatic involvement, hepatic involvement is usually asymptomatic and it is un-derdiagnosed. Here, we report a case of a patient with a history of pulmonary sarcoidosis who developed he-patic sarcoidosis. Case Report: 68-year-old female with pulmonary sarcoidosis with a 2-week history of severe abdominal pain and epigas-tric tenderness presented to our center. Abdominal magnetic resonance imaging (MRI) demonstrated mild he-patic fibrosis and cirrhosis. A thorough workup was performed including a liver biopsy which showed chronic non-necrotizing granulomas consistent with sarcoidosis. She was started on prednisone and subsequently improved. The patient was symptom-free on follow-up 1 month later. Conclusions: The majority of patients with hepatic sarcoidosis are usually asymptomatic, with only 5–30% presenting with abdominal pain, jaundice, nausea, vomiting, and hepatosplenomegaly. In rare cases, hepatic sarcoidosis can lead to cholestasis, portal hypertension, cirrhosis, or Budd-Chiari syndrome. Treatment with steroids is the mainstay of therapy; however, in severe cases, patients may require liver transplantation. This case report demonstrates that hepatic sarcoidosis is a serious condition, and if not treated, can lead to portal hypertension and cirrhosis. In patients with sarcoidosis, early detection and longitudinal follow-up is important in preventing overt liver failure. 1212 Indexed in: [PMC] [PubMed] [Emerging Sources Citation Index (ESCI)] [Web of Science by Clarivate] This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0)
Annals of Hepatology, 2006
Sarcoidosis is a multisystem disease of unknown aetiology. Histological evidence of non-caseating granulomas represents the main finding. It affects mostly young people, targeting primary the lung and hilar lymph nodes although liver involvement is often encountered. Hepatic sarcoidosis covers a broad spectrum from asymptomatic hepatic granulomas formation and slightly deranged liver function tests to clinically evident disease with cholestasis or, in advanced cases, cirrhosis and portal hypertension. Other granulomatous diseases (mainly systemic infections like tuberculosis) should be excluded prior to treatment, as longstanding corticosteroid administration is the main stem of therapy. In advanced cases, liver transplantation represents the ultimate therapeutic option.
Hepatic Sarcoidosis: An Uncommon Cause of Cirrhosis
Cureus
Sarcoidosis is a multi-organ inflammatory disease of unclear etiology. The hallmark of the disease is the formation of non-caseating granulomas. The prevalence of sarcoidosis is 5-30% in the general population and up to 80% in autopsy series. Hepatic involvement is seen in almost 50% of cases of sarcoidosis, though the clinical consequences are variable. In this study, we describe the case of three patients from our institution with hepatic sarcoidosis. Two of them eventually went on to develop liver cirrhosis.