Improvement of liver histology in hepatic sarcoidosis due to treatment with corticosteroids and ursodeoxycholic acid : a case report
© 2024. Japanese Society of Gastroenterology..
We report the case of a 48-year-old male with a history of pulmonary and ocular sarcoidosis. Non-caseating granulomas, identified histologically, are the most characteristic manifestation of sarcoidosis. Hepatic sarcoidosis is difficult to diagnose using radiological imaging. In the patient reported in this study, ultrasound and contrast-enhanced computed tomography scans identified multiple intra-abdominal lymphadenopathies, with evidence of liver and splenic infiltrations. The first liver biopsy revealed non-caseating granulomatous hepatitis consistent with hepatic sarcoidosis. The patient was treated with ursodeoxycholic acid (UDCA), but his laboratory parameters did not improve. Prednisone was initiated at a dose of 30 mg daily and slowly tapered. At a dose of 12.5 mg daily, marked improvements in the fibrotic and sarcoid-like lesions were noted at the second biopsy. A third biopsy was performed, with the patient on a prednisone taper of 5 mg/day showed mild fibrous expansion in the portal tracts and mild parenchymal necro-inflammatory lesions. However, overall, fibrosis marker levels remained stable over the course of treatment. A fourth biopsy was performed after a 5-year course of 5 mg/day prednisone. This revealed minimal lobular inflammation without fibrosis. Thus, treatment of this patient with corticosteroids and UDCA resulted in marked improvements in his biochemical and histological parameters.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:17 |
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| Enthalten in: |
Clinical journal of gastroenterology - 17(2024), 2 vom: 31. März, Seite 327-333 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kikuchi, Mayuko [VerfasserIn] |
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| Links: |
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| Themen: |
724L30Y2QR |
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| Anmerkungen: |
Date Completed 25.03.2024 Date Revised 25.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1007/s12328-023-01918-3 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM367897121 |
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| 100 | 1 | |a Kikuchi, Mayuko |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Improvement of liver histology in hepatic sarcoidosis due to treatment with corticosteroids and ursodeoxycholic acid |b a case report |
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| 520 | |a © 2024. Japanese Society of Gastroenterology. | ||
| 520 | |a We report the case of a 48-year-old male with a history of pulmonary and ocular sarcoidosis. Non-caseating granulomas, identified histologically, are the most characteristic manifestation of sarcoidosis. Hepatic sarcoidosis is difficult to diagnose using radiological imaging. In the patient reported in this study, ultrasound and contrast-enhanced computed tomography scans identified multiple intra-abdominal lymphadenopathies, with evidence of liver and splenic infiltrations. The first liver biopsy revealed non-caseating granulomatous hepatitis consistent with hepatic sarcoidosis. The patient was treated with ursodeoxycholic acid (UDCA), but his laboratory parameters did not improve. Prednisone was initiated at a dose of 30 mg daily and slowly tapered. At a dose of 12.5 mg daily, marked improvements in the fibrotic and sarcoid-like lesions were noted at the second biopsy. A third biopsy was performed, with the patient on a prednisone taper of 5 mg/day showed mild fibrous expansion in the portal tracts and mild parenchymal necro-inflammatory lesions. However, overall, fibrosis marker levels remained stable over the course of treatment. A fourth biopsy was performed after a 5-year course of 5 mg/day prednisone. This revealed minimal lobular inflammation without fibrosis. Thus, treatment of this patient with corticosteroids and UDCA resulted in marked improvements in his biochemical and histological parameters | ||
| 650 | 4 | |a Case Reports | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Corticosteroids | |
| 650 | 4 | |a Hepatic sarcoidosis | |
| 650 | 4 | |a Liver histology | |
| 650 | 7 | |a Prednisone |2 NLM | |
| 650 | 7 | |a VB0R961HZT |2 NLM | |
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| 700 | 1 | |a Koizumi, Aritoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Namisaki, Tadashi |e verfasserin |4 aut | |
| 700 | 1 | |a Asada, Shouhei |e verfasserin |4 aut | |
| 700 | 1 | |a Oyama, Masafumi |e verfasserin |4 aut | |
| 700 | 1 | |a Tomooka, Fumimasa |e verfasserin |4 aut | |
| 700 | 1 | |a Fujimoto, Yuki |e verfasserin |4 aut | |
| 700 | 1 | |a Kitagawa, Koh |e verfasserin |4 aut | |
| 700 | 1 | |a Kawaratani, Hideto |e verfasserin |4 aut | |
| 700 | 1 | |a Yoshiji, Hitoshi |e verfasserin |4 aut | |
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