Liver involvement in sarcoidosis is variable and can occur in the absence of pulmonary disease.
Data on the natural history of hepatic sarcoid and response to therapy are lacking.
Dr Patrick Kennedy and colleagues investigated hepatic dysfunction complicating lung disease.
The research team also assessed significant liver involvement presenting independent of pulmonary sarcoid.
The team included 180 patients in the study, which had a minimum follow-up of 2 years.
The researchers found that 50% of the study population had derangement of liver function attributable to hepatic sarcoid.
|50% receiving immunosuppressive drugs responded to treatment|
|European Journal of Gastroenterology & Hepatology|
The team noted that 13% of patients had liver involvement without lung disease.
Of 63 patients administered corticosteroids, about 33% had a complete clinical response, 33% a partial response and a further 33% showed no response.
The team observed that 8% of patients were cirrhotic at presentation, and 3% of patients progressed to cirrhosis despite steroid therapy.
The research team reported that 16 patients received a second-line immunosuppressive agent.
About half of these patients showed a response to treatment augmentation.
The researchers identified 6 patients that required liver transplantation, with disease recurrence in 1 recipient.
In 4 patients, sarcoid as the etiology of end-stage liver disease was diagnosed only on examination of the explanted liver.
Dr Kennedy's team concluded, “Sarcoidosis can cause end-stage chronic liver disease, which is often unrecognized until examination of the explanted liver.”
“Response to conventional immunosuppression is variable and unpredictable.”
“Transplantation is feasible and safe in this population but recurrence is possible.”