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 23 February 2018

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News

Clinical characteristics and outcome of hepatic sarcoidosis

This month's issue of the American Journal of Gastroenterology examines the clinical characteristics and outcome of hepatic sarcoidosis.

News image

Data on clinical manifestations and outcome of hepatic sarcoidosis are scarce.

Dr Patompong Ungprasert and colleagues from Minnesota, USA used a population-based cohort of patients with incident sarcoidosis to better describe the characteristics of hepatic sarcoidosis.

A cohort of incident cases of sarcoidosis in Olmsted County from 1976 to 2013 was identified from the database.

Diagnosis was verified by individual medical record review.

The team then reviewed confirmed cases of sarcoidosis for liver involvement.

Data on clinical manifestations, imaging study, liver biochemical tests, treatment, and outcome were collected.

Involvement of the liver by sarcoidosis was seen in 6%
American Journal of Gastroenterology

The researchers estimated cumulative incidence of cirrhosis adjusted for the competing risk of death.

A total of 345 cases of incident sarcoidosis were identified.

Of these, the team found that 6% had liver involvement.

The researchers noted that most patients had asymptomatic liver disease and were discovered in pursuit of abnormal biochemical tests and imaging studies.

Alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) were elevated in the majority of patients.

Elevated transaminases were less common and less severe.

The team noted that about half of patients had abnormal imaging study with hypodense nodular lesions being the most common abnormality followed by hepatomegaly.

The research team observed that liver biopsy revealed non-caseating granuloma in 88%.

A total of 4 patients developed cirrhosis.

Dr Ungprasert's team comments, "Involvement of the liver by sarcoidosis was seen in 6% of patients with sarcoidosis."

"The majority of patients were asymptomatic."

"Elevated ALP and GGT were the most common abnormal biochemical tests."

"Liver biopsy revealed non-caseating granuloma in almost all cases."

"Cirrhosis was seen in a significant number of patients."

"Generalizability of the observations to other populations may be limited, as the studied population was predominantly Caucasian."

"The prevalence of liver disease may be higher in more diverse populations."

Am J Gastroenterol 2017; 112:1556–1563
23 October 2017

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