title: A histologically proven case of progressive liver sarcoidosis with variceal rupture.
abstract: Sarcoidosis is a chronic multi-systemic granulomatous disease, and liver involvement frequently occurs. in most cases, no evidence of liver dysfunction is observed, and portal hypertension due to sarcoid liver diseases is a rareoccurrence. Moreover, no case of liver sarcoidosis has ever been reported with confirmation 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 emergency endoscopic injection sclerotherapy, and clear evidence of chronic hepatic failure. Twelve years ago, she was diagnosed as having sarcoidosis with respiratory clinicalsymptoms. 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.
authors: Hitoshi Yoshiji, Kou Kitagawa, Ryuichi Noguchi, Masahito Uemura, Yasuhide Ikenaka, Yosuke Aihara, Keisuke Nakanishi, Yusaku Shirai, Chie Morioka, Hiroshi Fukui, Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara 634-8522, Japan.
authors: Hitoshi
authors: H
authors: Yoshiji
authors: Kou
authors: K
authors: Kitagawa
authors: Ryuichi
authors: R
authors: Noguchi
authors: Masahito
authors: M
authors: Uemura
authors: Yasuhide
authors: Y
authors: Ikenaka
authors: Yosuke
authors: Y
authors: Aihara
authors: Keisuke
authors: K
authors: Nakanishi
authors: Yusaku
authors: Y
authors: Shirai
authors: Chie
authors: C
authors: Morioka
authors: Hiroshi
authors: H
authors: Fukui