Extrapulmonary sarcoidosis primarily diagnosed in the liver

Area of Science:

• Hepatology
• Immunology
• Pulmonology

Background:

• Sarcoidosis is a multisystem granulomatous disease of unknown etiology.
• The lungs are the most commonly affected organ, but hepatic involvement can occur.

Observation:

• A 73-year-old patient presented with fatigue, weight loss, and elevated alkaline phosphatase.
• Initial treatments were ineffective; a liver biopsy confirmed systemic sarcoidosis without lung or lymph node involvement.

Findings:

• Prednisone treatment led to normalization of liver enzymes, sustained over a 2-year follow-up.
• This case emphasizes hepatic sarcoidosis presenting primarily with liver enzyme abnormalities.

Implications:

• Sarcoidosis should be considered in the differential diagnosis of unexplained hepatic granulomas.
• Accurate diagnosis is crucial, as corticosteroid treatment for sarcoidosis can be detrimental if granulomas are infectious.