What Are the Clinical Characteristics of Hepatic Sarcoidosis?

About 50% of patients had an abnormal imaging study
About 50% of patients had an abnormal imaging study

Incident hepatic sarcoidosis (HS) is associated with adverse outcomes and liver abnormalities, new research shows.

Because data regarding clinical manifestations and outcomes of incident HS are scarce, the researchers used a population-based cohort of patients with HS to better describe the characteristics and outcomes of this condition.

The researchers began by analyzing a cohort of incident cases of sarcoidosis (n=345) and then further narrowed their analyses to focus on liver involvement in these cases based on imaging studies, liver biochemical tests, treatment, and outcome. Additionally, cumulative incidence of cirrhosis adjusted for the competing risk of death was estimated. 

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Of the 345 cases, 19 cases (6%) had liver involvement (mean age 46.1 years, 53% female and 79% Caucasian). Most patients were asymptomatic and the diagnosis was discovered in pursuit of other abnormal biochemical tests and imaging studies. In the majority of patients, alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) were elevated (88 and 90%, respectively). However, elevated transaminases were less common and less severe. About 50% of patients had abnormal imaging, with hypodense nodular lesions being the most common abnormality (6 patients) followed by hepatomegaly (3 patients). In 88% of cases (14 out of 16 patients), liver biopsy revealed non-caseating granuloma. A total of 4 patients developed cirrhosis.

The researchers acknowledged that their study had limitations. “Generalizability of the observations to other populations may be limited, as the studied population was predominantly Caucasian. The prevalence of liver disease may be higher in more diverse populations.”

Reference

Ungprasert P, Crowson CS, Simonetto DA, Matteson EL. Clinical Characteristics and Outcome of Hepatic Sarcoidosis: A Population-Based Study 1976-2013. Am J Gastroenterol. 2017 Sep 5. [Epub ahead of print]