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Hepatic sarcoidosis resembling primary sclerosing cholangitis
Ying Chen1, Camelia Ciobanu2, Laurel Mohrmann3
1Internal Medicine, Montefiore Medical Center, Bronx, New York, USA ychen3@montefiore.org.
BMJ Case Reports
|September 8, 2021
Summary
This case study highlights biliary sarcoidosis, a rare cause of obstructive jaundice and liver injury. Early diagnosis and steroid treatment significantly improved patient symptoms, underscoring the importance of considering sarcoidosis in unexplained cholestasis.
Area of Science:
- Hepatology
- Gastroenterology
- Immunology
Background:
- Sarcoidosis is a multisystem inflammatory disease of unknown etiology.
- Hepatic involvement in sarcoidosis is common but often asymptomatic.
- Biliary sarcoidosis, a rare manifestation, can mimic other cholestatic liver diseases.
Observation:
- A 29-year-old man presented with weight loss, night sweats, abdominal pain, and pruritus.
- Laboratory tests revealed obstructive jaundice and a cholestatic pattern of liver injury.
- Magnetic resonance cholangiopancreatography suggested primary sclerosing cholangitis.
Findings:
- Liver biopsy confirmed biliary sarcoidosis as the cause of the patient's symptoms.
- Hepatic sarcoidosis can present with significant cholestasis and hyperbilirubinemia.
- The patient's condition improved markedly after initiating corticosteroid therapy.
Implications:
- This case emphasizes the need to consider sarcoidosis in the differential diagnosis of unexplained obstructive jaundice.
- Early recognition and treatment of biliary sarcoidosis can lead to favorable outcomes.
- Further research into the pathogenesis and management of hepatic sarcoidosis is warranted.
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