title: Hepatic sarcoidosis: a case series.
abstract: Sarcoidosis is a systemic non caseous granulomas disease. Liver is a common location but usually asymptomatic. Evidence based guidelines for this location treatment is lacking and the effect of corticosteroids may be inadequate. The aim of our study was to describe the clinical, biochemical, radiological and therapeutic features of seven patients with systemic sarcoidosis and liver involvement. A retrospective and descriptive monocentric study, over 3 years, including seven patients with systemic sarcoidosis and liver involvement. We included 5 women and 2 men with an average age of 43 years. Hepatic localization revealed sarcoidosis in 5 cases. Hepatomegaly was observed in all patients as well as abnormal serum liver function test reflected by anicteric cholestasis. Liver biopsy, showed in all granulomatous lesions consistent with sarcoidosis and severe fibrosis in 2 cases. Extra-hepatic manifestations were present in all patients represented mainly by pulmonary location. All patients were treated, five by corticosteroid and two with ursodeoxycholic acid (UDCA). Complete response was observed in one case, partial response in another case and corticosteroid refractoriness in one case. In two cases, corticosteroid therapy was introduced for less than 1 month, not allowing assessment of response. Antimalarials in combination with UDCA were used successfully in a patient with steroid-resistant liver disease. Liver involvement can reveal systemic sarcoidois. Given the risk of progression to severe liver disease, it must be screened in all patients with systemic sarcoidosis. Treatment is not systematic, and still based on corticosteroid therapy. In the absence of prospective randomized controlled trials, the efficacy of UDCA need to be proven.
authors: Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia.
authors: Rym
authors: R
authors: Ennaifer
authors: Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia.
authors: Shema
authors: S
authors: Ayadi
authors: Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia.
authors: Hayfa
authors: H
authors: Romdhane
authors: Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia.
authors: Myriam
authors: M
authors: Cheikh
authors: Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia.
authors: Houda Ben
authors: HB
authors: Nejma
authors: Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia.
authors: Wassila
authors: W
authors: Bougassas
authors: Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia.
authors: Najet Bel
authors: NB
authors: Hadj
mesh_terms: D000328:Adult; D001706:Biopsy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006099:Granuloma / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D008107:Liver Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology*; D016896:Treatment Outcome; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D005938:Glucocorticoids; D014580:Ursodeoxycholic Acid
keywords: Sarcoidosis; cholestasis; corticosteroids; granuloma; liver