title: More on hepatic granulomas.
abstract: We have read the case report of Nihon-Yanagi et al. The patient they described developed hepatic granuloma two times and the granulomatous lesion was surrounding metal staples/clips suggesting that the granuloma was due to surgical staples/clips. Hepatic granulomas (HGs) are reported in around 5% of patient who undergo a liver biopsy and caused by several diseases including sarcoidosis, tuberculosis, hydatid cyst, brucellosis, typhoid fever, chronic hepatitis B and C and primary biliary cirrhosis (PBC). Chronic hepatitis B and C infections are the most common and serious causes of liver damage in patient with renal failure. Their prevalence is a higher than people without renal failure. We have previously reported that the prevalences of HGs in patients with chronic hepatitis B and C are 1.5 and 1.3% respectively. The described patient was on hemodialysis for 12 years. The other causes of HG seem excluded; however hepatitis B and C infections and PBC should have been tested and excluded before ascribing the HGs to surgical staples/clipping material.
authors.affiliation: Infectious Diseases Department, Cerrahpasa Medical School, Istanbul University, TR-34098, Cerrahpasa, Istanbul, Turkey. rozaras@yahoo.com.
authors.forename: Resat
authors.initials: R
authors.lastname: Ozaras
authors.affiliation: Infectious Diseases Department, Cerrahpasa Medical School, Istanbul University, TR-34098, Cerrahpasa, Istanbul, Turkey. yemisenmucahit@hotmail.com.
authors.forename: Mucahit
authors.initials: M
authors.lastname: Yemisen
authors.affiliation: Infectious Diseases Department, Cerrahpasa Medical School, Istanbul University, TR-34098, Cerrahpasa, Istanbul, Turkey. ilkerinancbalkan@hotmail.com.
authors.forename: Ilker Inanc
authors.initials: II
authors.lastname: Balkan
mesh_terms: D015745:Granuloma, Foreign-Body / Q000209:etiology*; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D006967:Hypersensitivity / Q000209:etiology*; D010535:Laparoscopy / Q000009:adverse effects*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D012811:Sigmoid Neoplasms / Q000601:surgery*; D013525:Surgical Instruments / Q000009:adverse effects*; D013537:Sutures / Q000009:adverse effects*; D014025:Titanium / Q000009:adverse effects*
chemical_list: D014025:Titanium