Improvement of liver histology in hepatic sarcoidosis due to treatment with corticosteroids and ursodeoxycholic acid: a case report.

Autor: Kikuchi M; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan., Koizumi A; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan., Namisaki T; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan. tadashin@naramed-u.ac.jp., Asada S; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan., Oyama M; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan., Tomooka F; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan., Fujimoto Y; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan., Kitagawa K; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan., Kawaratani H; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan., Yoshiji H; Department of Gastroenterology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, Japan.
Jazyk: angličtina
Zdroj: Clinical journal of gastroenterology [Clin J Gastroenterol] 2024 Apr; Vol. 17 (2), pp. 327-333. Date of Electronic Publication: 2024 Feb 01.
DOI: 10.1007/s12328-023-01918-3
Abstrakt: 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.
(© 2024. Japanese Society of Gastroenterology.)
Databáze: MEDLINE
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