Isolated Hepatic Sarcoidosis: A Case Report and Literature Review

Sarcoidosis is a multi-systemic disorder of unknown aetiology that primarily involves the pulmonary system with the histological hall mark of a non-caseating granuloma. Isolated hepatic involvement is a manifestation of sarcoidosis.

We report an incidental finding of hepatic sarcoidosis in a hypertensive and diabetic patient who presented with abdominal pain and fatigue.

A case report of sole diagnosis of hepatic sarcoidosis from a Gastroenterology service in Port Harcourt metropolis Nigeria. A literature search was made using the words 'sarcoidosis' and 'hepatic' in PubMed Central, Cochrane and Google search engines. From the search results, literature in English were extracted and reviewed.

The index case was referred on account of hepatomegaly with associated abdominal pain and fatigue. A diagnosis of isolated hepatic sarcoidosis was made from elevated liver enzymes, elevated angiotensin converting enzyme, sero-negative autoimmune studies, hepatomegaly with liver nodule on abdominal computerized tomography scan and non-caseating granuloma from liver biopsy. There was no evidence of other systems involvement.

Hepatic sarcoidosis is rare in African literature more so as no specific laboratory or radiological test is diagnostic. Delayed diagnosis and underreporting of hepatic sarcoidosis are likely in our environment due to the elaborate evaluation needed.