Hepatic sarcoidosis complicating treatment-naive viral hepatitis
- PMID: 23355920
- PMCID: PMC3554806
- DOI: 10.4254/wjh.v4.i12.402
Hepatic sarcoidosis complicating treatment-naive viral hepatitis
Abstract
Hepatic sarcoidosis is usually asymptomatic but rarely leads to adverse liver-related outcome. Co-existence of viral hepatitis and hepatic sarcoidosis is a rare, but recognised phenomenon. Obtaining a balance between immune suppression and anti-viral therapy may be problematic. Immunosuppression in the presence of viral hepatitis can lead to rapid deterioration of liver disease. Similarly, anti-viral therapy may exacerbate granulomatous hepatitis. Here we present two cases of viral hepatitis co-existing with sarcoidosis that illustrate successful management strategies. In one, hepatitis B replication was suppressed with oral anti-viral therapy before commencing prednisolone. In the second, remission of hepatic sarcoidosis was achieved with prednisolone, before treating hepatitis C and obtaining a sustained virological response with pegylated interferon and ribavirin therapy.
Keywords: Anti-viral therapy; Chronic hepatitis B infection; Chronic hepatitis C infection; Hepatic sarcoidosis; Immune suppression.
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References
-
- Newman LS, Rose CS, Maier LA. Sarcoidosis. N Engl J Med. 1997;336:1224–1234. - PubMed
-
- Devaney K, Goodman ZD, Epstein MS, Zimmerman HJ, Ishak KG. Hepatic sarcoidosis. Clinicopathologic features in 100 patients. Am J Surg Pathol. 1993;17:1272–1280. - PubMed
-
- Valla D, Pessegueiro-Miranda H, Degott C, Lebrec D, Rueff B, Benhamou JP. Hepatic sarcoidosis with portal hypertension. A report of seven cases with a review of the literature. Q J Med. 1987;63:531–544. - PubMed
-
- Ayyala US, Padilla ML. Diagnosis and treatment of hepatic sarcoidosis. Curr Treat Options Gastroenterol. 2006;9:475–483. - PubMed
-
- Coiffier B. Hepatitis B virus reactivation in patients receiving chemotherapy for cancer treatment: role of Lamivudine prophylaxis. Cancer Invest. 2006;24:548–552. - PubMed
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