title: Primary biliary cirrhosis and hepatic sarcoidosis--a case report.
abstract: BACKGROUND
  Primary biliary cirrhosis (PBC) is an immune-mediated chronic progressive inflammatory liver disease leading to destruction of small interlobular bile ducts. Sarcoidosis is a chronic disorder of unknown etiology characterized by non-caseous granulomas.
  
  
  METHODS
  We reported a 69-year-old female patient with abdominal pain, malaise, vertigo, headaches, hands tremor and partial loss of hearing. Initial laboratory findings revealed elevated liver function tests and cholesterol with positive antimytochondrial and antinuclear antibodies. Liver biopsy revealed granuloma typical for PBC and granulomatous lesions typical for sarcoidosis. Elevated serum angiotensin-converting enzyme and granulomatous lesion on the brain magnetic resonance imaging (MRI) were detected and the patient was diagnosed with overlap of PBC and liver sarcoidosis and neurosarcoidosis. The patient was treated with ursodeoxicholic acid (UDCA) and prednisolone. Six months later the patient was symptom-free with laboratory findings within normal range.
  
  
  CONCLUSIONS
  In PBC patients it is important to consider coexisting granulomatous liver diseases if elevated liver function tests persist despite UDCA therapy.
authors: Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia. tamara.alempijevic@med.bg.ac.rs
authors: Tamara
authors: T
authors: Alempijević
authors: Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia.
authors: Aleksandra
authors: A
authors: Sokić-Milutinović
authors: Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia.
authors: Ljubisa
authors: L
authors: Toncev
authors: Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia.
authors: Aleksandra
authors: A
authors: Pavlović-Marković
authors: Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia.
authors: Srdjan
authors: S
authors: Djuranović
authors: Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
authors: Nada
authors: N
authors: Tomanović
authors: Clinic for Neurology, Clinical Center of Serbia, Belgrade, Serbia.
authors: Jelena
authors: J
authors: Drulović
mesh_terms: D000368:Aged; D001706:Biopsy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology*; D008105:Liver Cirrhosis, Biliary / Q000150:complications / Q000175:diagnosis*; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis*