A histologically proven case of progressive liver sarcoidosis with variceal rupture

Sarcoidosis is a chronic multi-systemic granulomatous disease,and liver involvement frequently occurs.in most cases,no evidence of liver dysfunction is ob-served,and portal hypertension due to sarcoid liver diseases is a rareoccurrence.Moreover,no case of liver sarcoidosis has ever been reported wit...

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Published inWorld journal of hepatology Vol. 3; no. 10; pp. 271 - 274
Main Authors Yoshiji, Hitoshi, Kitagawa, Kou, Noguchi, Ryuichi, Uemura, Masahito, Ikenaka, Yasuhide, Aihara, Yosuke, Nakanishi, Keisuke, Shirai, Yusaku, Morioka, Chie, Fukui, Hiroshi
Format Journal Article
LanguageEnglish
Published United States Baishideng Publishing Group Co., Limited 27.10.2011
Subjects
Case Report
cirrhosis
failure
He-patic
hypertension
Liver
Portal
sarcoidosis
Hepatic failure
Liver sarcoidosis
Liver cirrhosis
Portal hypertension
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Summary:Sarcoidosis is a chronic multi-systemic granulomatous disease,and liver involvement frequently occurs.in most cases,no evidence of liver dysfunction is ob-served,and portal hypertension due to sarcoid liver diseases is a rareoccurrence.Moreover,no case of liver sarcoidosis has ever been reported with confirma-tion of the disease progression.Herein we describe a patient having hepatic sarcoidosis with severe portal hypertension and liver dysfunction.The diagnosis was histologically confirmed from granulomatous status to established liver cirrhosis over 10 years.A 46-year-old woman developed massive hematemesis due to the rupture of gastric cardial varices.She underwent emer-gency endoscopic injection sclerotherapy,and clear evi-dence of chronic hepatic failure.Twelve years ago,she was diagnosed as having sarcoidosis with respiratoryclinicalsymptoms.Liver biopsy revealed asymptomatic incidental granulomas without fibrosis development.After a couple of years,features of liver dysfunction were manifest and progressed.Ten years after the first biopsy,a second liver biopsy was performed,and well established dense fibrosis was revealed.Although significant liver dysfunction with portal hypertension is rarely seen in sarcoidosis,this case indicates that we have to consider the possibility that sarcoidosis may cause end-stage liver cirrhosis.
Bibliography:Hitoshi Yoshiji,Kou Kitagawa,Ryuichi Noguchi,Masahito Uemura,Yasuhide Ikenaka,Yosuke Aihara,Keisuke Na-kanishi,Yusaku Shirai,Chie Morioka,Hiroshi Fukui,Third Department of Internal Medicine,Nara Medical University,Kashihara,Nara 634-8522,Japan
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Author contributions: Yoshiji H and Kitagawa K described the clinical case, obtained informed consent from the patient, conceived the study, participated in its design, assisted in data collection, coordinated and helped draft the manuscript; Yoshiji H undertook the literature research and contributed to the writing; Uemura M, Ikenaka Y, Noguchi R, Shirai Y, Aihara Y, Nakanishi K, Morioka C and Fukui H were responsible for the diagnosis, patient management and review.
Telephone: +81-744-223051 Fax: +81-744-247122
Correspondence to: Hitoshi Yoshiji, MD, PhD, Third Department of Internal Medicine, Nara Medical University, Shijo-cho 840, Kashihara, Nara 634-8522, Japan. yoshijih@naramed-u.ac.jp
ISSN:1948-5182
1948-5182
DOI:10.4254/wjh.v3.i10.271