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Case Reports
. 2022 Oct 12;9(10):e00874.
doi: 10.14309/crj.0000000000000874. eCollection 2022 Oct.

Reversal of Clinically Significant Portal Hypertension After Immunosuppressive Treatment in a Patient With Sarcoidosis

David Yardeni  1 , Julian Hercun  1 , Gracia Viana Rodriguez  1 , Joseph R Fontana  2 , David E Kleiner  3 , Christopher Koh  1 , Theo Heller  1
Affiliations
Case Reports

Reversal of Clinically Significant Portal Hypertension After Immunosuppressive Treatment in a Patient With Sarcoidosis

David Yardeni et al. ACG Case Rep J. .

Abstract

Sarcoidosis is a multisystemic disease which features non-necrotizing granulomas in lungs and other organs. Hepatic involvement in sarcoidosis varies between a mild asymptomatic disease and a progressive inflammatory granulomatous disease with or without cirrhosis. In this case presentation, we present a case of hepatic sarcoidosis complicated by clinically significant portal hypertension including splenomegaly and gastroesophageal varices successfully treated with immunosuppression to achieve portal hypertension reversal.

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Figures

Figure 1.
Figure 1.
T2-weighted magnetic resonance imaging showing (A) craniocaudal splenomegaly. (B) Prominent gastroesophageal varices and prominent splenorenal collaterals.
Figure 2.
Figure 2.
Histological findings. (A) Well-formed, non-necrotizing granulomas involving a portal area (hematoxylin and eosin, 200×). (B) Nodular regenerative hyperplasia changes with liver cell plate width variation (reticulin, 200×). (C) Abnormal staining of sinusoidal endothelial cells with CD34 (anti-CD34 stain, 200×).
Figure 3.
Figure 3.
(A and B) T2-weighted magnetic resonance imaging showing resolved splenomegaly.
See this image and copyright information in PMC

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