Recurrent hepatic sarcoidosis post-liver transplantation manifesting with severe hypercalcemia: a case report and review of the literature.
Sarcoidosis is a systemic granulomatous disease primarily involving the lungs, lymph nodes, skin, eyes and nervous system; liver involvement is asymptomatic in most cases. However, once the patient develops clinical symptoms liver disease is usually progressive and may necessitate orthotopic liver transplantation. There are a few reports of asymptomatic recurrent sarcoidosis developing within the liver allograft. We report a case of early recurrence of sarcoidosis in the liver allograft diagnosed on biopsy in a patient who presented with severe hypercalcemia, kidney dysfunction, and increase in size of abdominal lymph nodes. The liver chemistry tests were within normal limits. The patient responded well to steroid treatment by normalizing serum calcium and creatinine levels and reducing lymph node size. To date, there has been no report in the literature of symptomatic recurrence of hepatic sarcoidosis following orthotopic liver transplantation.
Cengiz
Cem
C
Recanati/Miller Transplantation Institute, The Mount Sinai School of Medicine, PO Box 1504, New York, NY 10029-6574, USA.
Rodriguez-Davalos
Manuel
M
deBoccardo
Graciela
G
Fiel
M Isabel
MI
Rodriguez-Laiz
Gonzalo
G
Kovacevic
Mark
M
Emre
Sukru
S
Schiano
Thomas
T
D000328:Adult; D001706:Biopsy; D002118:Calcium / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000188:drug therapy / Q000209:etiology*; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology; D016031:Liver Transplantation / Q000009:adverse effects* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence; D012507:Sarcoidosis / Q000188:drug therapy / Q000209:etiology* / Q000473:pathology
D005938:Glucocorticoids; D011239:Prednisolone; D002118:Calcium