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Review
. 2013 Dec;1(2):87-93.
doi: 10.14218/JCTH.2013.00016. Epub 2013 Dec 15.

Hepatic Sarcoidosis

Micheal Tadros  1 , Faripour Forouhar  2 , George Y Wu  1
Affiliations
Review

Hepatic Sarcoidosis

Micheal Tadros et al. J Clin Transl Hepatol. 2013 Dec.

Abstract

Sarcoidosis is a multisystem disease characterized by the presence of non-caseating granulomas in affected organs. Pulmonary involvement is the most common site of disease activity. However, hepatic involvement is also common in sarcoidosis, occurring in up to 70% of patients. Most patients with liver involvement are asymptomatic. Therefore, the majority of cases are discovered incidentally, frequently by the finding of elevated liver enzymes. Pain in the right upper quadrant of the abdomen, fatigue, pruritus, and jaundice may be associated with liver involvement. Portal hypertension and cirrhosis are complications linked to long-standing hepatic sarcoidosis. Liver biopsy is usually required to confirm the diagnosis. It is important to differentiate hepatic sarcoidosis from other autoimmune and granulomatous liver diseases. Not all cases of hepatic sarcoidosis require treatment. For symptomatic patients, the first line treatment includes corticosteroids or ursodeoxycholic acid. Various immunosuppressant agents can be used as second line agents. Rarely, severe cases require liver transplantation.

Keywords: Epitheloid; Granuloma; Sarcoid.

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Conflict of interest statement

Conflict of interest: None

Figures

Fig. 1
Fig. 1. A liver biopsy specimen showing a single portal epithelioid granuloma (arrow) surrounded by a thin cuff of lymphocytes
H&E, ×100.
Fig. 2
Fig. 2. A liver biopsy specimen showing: a, a conglomerate of granulomatous reaction (arrow) with significant fibrosis (arrow head); b, significant as well conglomerate of epithelioid granulomas with giant cells (arrow), but without necrosis
Trichrome, ×400.
Fig. 3
Fig. 3. A liver biopsy specimen showing a sarcoid granuloma in liver with central fibrinoid necrosis (arrow)
H&E, ×400.
See this image and copyright information in PMC

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