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Hepatobiliary disease in sarcoidosis
Charles J Kahi1, Romil Saxena, M'Hamid Temkit
1Department of Medicine, Division of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana, USA.
Summary
Hepatobiliary disease in sarcoidosis is uncommon and often asymptomatic. Male gender and splenomegaly are risk factors for liver involvement in sarcoidosis patients.
Area of Science:
- Hepatology
- Immunology
- Internal Medicine
Background:
- Sarcoidosis is a multisystem granulomatous disease with unknown causes.
- The prevalence, patterns, and risk factors of hepatobiliary disease in sarcoidosis patients are not well understood.
Purpose of the Study:
- To investigate the prevalence, clinical presentation, and risk factors of hepatobiliary disease in patients with sarcoidosis.
Main Methods:
- Retrospective review of sarcoidosis patients diagnosed between 1976 and 2002.
- Liver disease defined by abnormal liver tests; comparison between patients with and without liver abnormalities.
- Analysis of liver biopsy findings and associated clinical factors.
Main Results:
- Of 1,436 sarcoidosis patients, 340 had abnormal liver tests; 34 underwent biopsy, showing portal inflammation (85%), bile duct depletion (50%), and fibrosis/cirrhosis (26%).
- Male gender, hepatomegaly, splenomegaly, and normal chest X-ray were associated with hepatic sarcoidosis.
- Multivariate analysis identified male gender (OR 2.8) and splenomegaly (OR 9.2) as significant predictors of liver disease.
Conclusions:
- Hepatobiliary disease in sarcoidosis is often subclinical, ranging from abnormal liver tests to cirrhosis.
- Male gender and splenomegaly are significantly associated with sarcoid-related liver disease.
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