Isolated hepatic sarcoidosis

Introduction: Sarcoidosis is a multisystem, granulomatous disease of unknown etiology. Although the hepatic granulomas occurs in 50-65% of patients with systemic sarcoidosis, isolated liver sarcoidosis is rare. The clinical presentation varies from asymptomatic to manifest. Diagnosis is based on characteristic histopathological finding of liver biopsy. Case report: A 69-year old man was admitted due to abdominal swelling and abdominal pain. Laboratory studies detected: cholestasis, pancytopenia and elevaton of Angiotensin-Converting Enzyme. Abdominal imaging techniques showed liver cirrhosis, splenomegaly and ascites. The diagnosis of the hepatic sarcoidosis was confirmed by histopathological examination of liver biopsy. The patient was treated with corticosteroids. After 18 months, the patient was without any subjective symptoms, with biochemical and clinical improvement. Conclusion: In isolated hepatic sarcoidosis should be considered in the differential diagnosis in asymptomatic or manifest patients with hepatosplenomegaly and changes in liver functional tests. Only the timely diagnosis and proper treatment can lead to subjective and objective improvement of patients.