Journal of Yeungnam Medical Science

Case report

Gastroenterology and Hepatology
Primary hepatic sarcoidosis presenting with cholestatic liver disease and mimicking primary biliary cholangitis: a case report: Young Joo Park, Hyun Young Woo, Moon Bum Kim, Jihyun Ahn, Jeong Heo; J Yeungnam Med Sci. 2022;39(3):256-261. Published online August 10, 2021; DOI: https://doi.org/10.12701/yujm.2021.01151

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Sarcoidosis often involves the liver. However, primary hepatic sarcoidosis confined to the liver without evidence of systemic involvement is rare. We report the case of a 37-year-old man with hepatic sarcoidosis who initially presented with elevated liver enzymes and suspicious cirrhotic nodules on computed tomography. The patient had cirrhosis but did not have portal hypertension. Based on the initial histopathologic finding of chronic granulomatous inflammation and the common clinical characteristics of sarcoidosis, he was initially diagnosed with primary biliary cholangitis, and his daily dosage of ursodeoxycholic acid was increased to 900 mg. After 14 months of treatment, his total serum bilirubin concentration was 10.9 mg/dL (upper normal limit, 1.2 mg/dL). Additionally, a transjugular liver biopsy revealed multiple noncaseating granulomas. He was diagnosed with primary hepatic sarcoidosis involving the lungs, heart, spleen, kidneys, and skin. Treatment with methylprednisolone was initiated. Two weeks later, he was started on azathioprine, and the dose of steroid was simultaneously reduced. These findings indicate the importance of including hepatic sarcoidosis as a possible diagnosis in patients with elevated liver enzymes or cryptogenic cirrhosis.

Citations

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Hepatic Sarcoidosis Mimicking a Metastatic Tumor: A Case Report
Naohiro Nakamura, Yoshiki Mastsuno, Kazunori Aoi, Hisashi Kosaka, Sanshiro Kobayashi, Yu Takahashi, Tomomitsu Tahara, Yuri Noda, Koji Tsuta, Makoto Naganuma
Internal Medicine.2025;[Epub] CrossRef
Liver biopsy as a useful diagnostic tool for hepatic sarcoidosis: A case report
Kenrei Uehara, Tatsuo Kanda, Shuhei Arima, Mai Totsuka, Masayuki Honda, Ryota Masuzaki, Reina Sasaki‑tanaka, Naoki Matsumoto, Masahiro Ogawa, Hirofumi Kogure
Medicine International.2024;[Epub] CrossRef
Navigating Challenges in a Case of Unusual Hepatic and Pulmonar Sarcoidosis: A Comprehensive Clinical Journey
André Gonçalves, Diogo Simas, Plácido Gomes, Carina Leal, Catarina Atalaia-Martins, Helena Vasconcelos
GE - Portuguese Journal of Gastroenterology.2024; : 1. CrossRef
The clinical management of hepatic sarcoidosis: A systematic review
Ram Prasad Sinnanaidu, Vikneshwaran Chandra Kumar, Ranita Hisham Shunmugam, Sanjiv Mahadeva
JGH Open.2024;[Epub] CrossRef
Gastrointestinal Manifestations of Sarcoidosis: A State-of-the-Art, Comprehensive Review of the Literature—Practical Clinical Insights and Many Unmet Needs on Diagnosis and Treatment
Salvatore Nicolosi, Maria Chernovsky, Darina Angoni, Michael Hughes, Giulia Bandini, Zsuzsanna McMahan, Marta Maggisano, Francesco Salton, Lucrezia Mondini, Mariangela Barbieri, Gianluca Screm, Marco Confalonieri, Elisa Baratella, Paola Confalonieri, Barb
Pharmaceuticals.2024; 17(9): 1106. CrossRef
An Incidental Case of Sarcoidosis in a Young Male Patient Presenting With Symptomatic Chronic Cholecystitis
Kelsey A Clabby, Yelena Piazza, Vladimir Neychev
Cureus.2024;[Epub] CrossRef

Case Report

Oncology and Cancer Research
Immune thrombocytopenia associated with sarcoidosis.: Da Eun Jeong, Min Kyoung Kim, Sung Ae Koh, Kyoung Hee Lee, Joon Hyuk Choi, Young Hoon Hong, Jae Ho Cho, Eun Ju Goo, Myung Soo Hyun; Yeungnam Univ J Med. 2015;32(1):26-30. Published online June 30, 2015; DOI: https://doi.org/10.12701/yujm.2015.32.1.26

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Abstract PDF: Sarcoidosis is a systemic disease of unknown cause involving multiple organs and is characterized by noncaseating granuloma. Immune thrombocytopenia (ITP) is an autoimmune disease characterized by increased peripheral platelet destruction due to the presence of an antibody to the platelet and abnormal platelet production. There is no known pathogenesis that occurs concurrently with ITP and sarcoidosis. However, considering together of 2 known pathogenesis, abnormal immune response triggers either ITP or sarcoidosis. The disease that develops first stimulates secondary disease. After development of secondary disease, they stimulate each other. A few cases of ITP associated with sarcoidosis are well documented in English; however, the disease has rarely been reported in Korea. Here, we report on a case of ITP with sarcoidosis in a 29-year-old man. He suffered from easy bruising. The chest X-ray and the contrast-enhanced computed tomography scan showed bihilar lymphadenopathy and reticulonodular infiltrates. Bone marrow study and fluoroscopy-guided percutaneous needle biopsy were performed and the patient was diagnosed with sarcoidosis and ITP. He was put on 400 mg/kg of intravenous immunoglobulin for 5 days and administered oral steroids and further follow-up will be carried out. He has shown a good response without significant bleeding event. However, administration of more oral steroid and additional follow-up is required than for single disease, whether sarcoidosis or ITP.

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