Hepatic granuloma: decreasing trend in a high-incidence area
Faisal M Sanai1, Suhail Ashraf, Ayman A Abdo
1Department of Medicine, Division of Gastroenterology and Hepatology, Riyadh Military Hospital, Riyadh, Saudi Arabia. fsanai@rmh.med.sa
Summary
The incidence of hepatic granuloma (HG) in Saudi Arabia is lower than previously reported. Tuberculosis and viral hepatitis are the main causes, with fever and weight loss indicating tuberculosis.
Area of Science:
- Hepatology
- Infectious Diseases
- Pathology
Background:
- Hepatic granuloma (HG) incidence in Saudi Arabia was previously reported at 14.6%.
- This study aimed to determine the local incidence, clinical presentation, and etiological factors of HG.
- Understanding HG prevalence is crucial for regional public health strategies.
Purpose of the Study:
- To ascertain the actual incidence of hepatic granuloma in the study region.
- To analyze the clinical and biochemical features of patients with HG.
- To identify the primary causes of HG, focusing on infectious and idiopathic origins.
Main Methods:
- A retrospective review of 5531 liver biopsies over 13 years.
- Patients were categorized into tuberculosis, viral hepatitis (B and C), and idiopathic groups.
- Demographic, clinical, and biochemical data were analyzed for each group.
Main Results:
- The incidence of HG was found to be 1.2% (66 patients).
- Infections accounted for 72.2% of cases, with tuberculosis (42.6%) and viral hepatitis (16.3%) being most prevalent.
- Fever and weight loss were significantly more common in tuberculous HG compared to other groups.
Conclusions:
- The actual incidence of HG in this region is significantly lower than previously suggested.
- Tuberculosis and viral hepatitis are the leading causes of HG, while schistosomiasis is rare.
- Clinical symptoms like fever and weight loss can help differentiate tuberculous HG.
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