Lp‐x Test in Sarcoidosis Patients With Liver Involvement: Comparison With Other Liver Function Tests

Abstract

In the serum of many patients with sarcoidosis, alkaline phosphatase activity is increased due to sarcoid liver involvement. A study was carried out of various tests expressing intrahepatic cholestasis in 26 patients with sarcoidosis, 18 of them with a positive liver biopsy and 8 with a negative liver biopsy. SAP was elevated in 23% of the patients and its thermoresistance pointed to an hepatic origin. The predictive value of a positive test (PV-positive, the percentage of times that a positive test is in agreement with an involved liver) and the predictive value of a negative test (PV-negative, the percentage of times that a negative test will detect a nondiseased liver) were calculated. LP-X test is more reliable than SAP, which in turn is better than CB, BSP retention, and gamma-glutamyl-transpeptidase, in that order. LP-X seems to be more specific and more sensitive than alkaline phosphatase for predicting liver involvement in sarcoidosis.

Liver-test abnormalities in sarcoidosis

“…In patients with asymptomatic hepatic sarcoidosis, Lebacq and Heller [26] found AP to be more reliable than g-glutamyl transaminase in predicting sarcoid liver involvement. Baughman et al [30] found higher levels of various liver tests, especially AP, in patients with liver sarcoidosis.…”

“…Moreover, diagnosis is considered to be a clinical challenge, because of the wide spectrum of disease presentation and course with the absence of specific symptoms, signs and radiological findings [3,8,[10][11][12][14][15][16][17][18][19][20][21]25]. Furthermore, liver-test abnormalities can be found in hepatic sarcoidosis; however, the clinical relevance of the severity of these abnormalities is uncertain [10][11][12]16,18,19,26]. Therefore, the aim of this study was to establish the presence and severity of the liver-test abnormalities in a Dutch sarcoidosis population and additionally, to evaluate the relationship between severity of liver-test abnormalities and histopathological abnormalities in hepatic sarcoidosis.…”

Multisystemic Sarcoidosis Revealed by Hepatosplenomegaly: A Case Report

“…Hepatomegaly is clinically present in 21% of patients, while more than half of the patients have hepatomegaly on abdominal CT scans [ 8 ]. ALP is more reliable to predict liver involvement than GGT [ 9 ]. The histological abnormalities in liver sarcoidosis include non-caseating granulomas, chronic intrahepatic cholestasis, periportal fibrosis, and the development of micronodular biliary cirrhosis [ 10 ].…”

Approaches to the treatment of some of the troublesome manifestations of sarcoidosis

“…Fatigue is a common symptom, and right upper quadrant abdominal pain may occur, but seldom pruritus and jaundice. Elevation of alkaline phosphatase levels is considered to be a more reliable sign of involvement than increased levels of transaminases, which are often only slightly elevated . Ultrasound, abdominal computed tomography (CT) scans and biopsies are useful diagnostic tools.…”