Clinical manifestations of sarcoid liver disease

Abstract

Sarcoidosis is a systemic granulomatous disease of unknown etiology that involves many organs and has different clinical manifestation. We reviewed the clinical manifestations of sarcoid liver disease. Liver involvement in sarcoidosis can be serious and life-threatening, independent of its lung and other organ involvement.

Liver-test abnormalities in sarcoidosis

“…Only 5-30% of the patients present with atypical clinical signs and symptoms such as nausea, vomiting, abdominal pain in the right upper quadrant, a painful liver during palpation and/or hepatomegaly [3,8,[10][11][12][14][15][16][17][18][19][20][21]. In a minority of patients, hepatic sarcoidosis can be a serious and rapid progressive disease with the occurrence of complications as cirrhosis, portal hypertension, chronic cholestasis and Budd-Chiari syndrome [3,4,8,10,13,14,17,[21][22][23][24]. Because symptomatic hepatic sarcoidosis is uncommon, studies to investigate the natural history and the diagnostic approach are scarce.…”

Diagnosis and treatment of hepatic sarcoidosis

“…Portal hypertension develops as a result of biliary fibrosis and cirrhosis [6]. Extrahepatic cholestatic changes are less common but can occur secondary to granulomas or lymphadenopathy, causing obstruction of the common bile duct [9,10]. Thrombosis of the hepatic veins with resulting Budd-Chiari syndrome is a rare manifestation of hepatic sarcoidosis that can occur from extrinsic compression by granulomas/inflammation, causing venous stasis and thrombosis [6,10].…”

“…However, a minority of patients progress to severe cholestatic jaundice, portal hypertension, Budd-Chiari syndrome, and cirrhosis [6,9,10]. This occurs in less than 1% of patients with sarcoidosis and may necessitate transplantation [10].…”

sarcoidosis and digesTiVe sysTem organs inVol VemenT

“…В биоптатах печени обнаружили неказеифицирующие эпителиоидные гранулемы [54]. Израильские интернисты отмечали, что поражение печени при саркоидозе может быть серьезным и даже угрожающим жизни, нередко вне зависимости от вовлечения в процесс легких или других органов [55]. Индийские исследователи наблюдали 50-летнюю женщину с поражением печени саркоидозом, что привело к портальной гипертензии [56].…”