Sarcoidosis is a systemic granulomatous disease which may involve many organs. In approximately 95% of patients there is liver involvement, with noncaseating hepatic granulomas occurring in 21 to 99% of patients with sarcoidosis. Liver involvement is usually asymptomatic and limited to mild to moderate abnormalities in liver biochemistry. The occurrence of jaundice in sarcoidosis is rare; extensive imaging procedures and the examination of liver biopsies permit a precise diagnostic. Ductopenia associated with sarcoidosis has been reported in less than 20 cases and can lead to biliary cirrhosis and liver- related death. We report here on a case of ductopenia-related sarcoidosis in which primary biliary cirrhosis and extrahepatic cholestasis have been carefully excluded. The patient follow up was 8 years. Although ursodesoxycholic acid appears to improve liver biochemistry it does not preclude the rapid occurrence of extensive fibrosis. A review of the literature of reported cases of ductopenia related to sarcoidosis is provided.
La péritonite encapsulante est une péritonite chronique aboutissant à une membrane fibreuse épaisse, blanc nacré. C'est une affection rare dont la physiopathologie reste mal expliquée et le diagnostic est souvent porté en peropératoire ; elle peut être la cause d'une urgence chirurgicale, le caractère idiopathique est exceptionnel, retrouvé chez l'adolescent provenant des régions tropicales et subtropicales, jamais dans le Maghreb. Nous rapportons l'observation d'une jeune patiente marocaine de 18 ans, opérée pour une occlusion intestinale, chez qui le diagnostic d'une péritonite encapsulante a été posé en peropératoire.
L'allopurinol est un inhibiteur de la synthèse de l'acide urique indiqué dans le traitement des hyperuricé-mies. Sa toxicité hépatique est rare. Nous rapportons un cas d'hépatite aiguë cytolytique imputable à la prise d'allopurinol chez un patient âgé de 65 ans sous bithérapie pour hépatite virale C.
Mots clés Allopurinol · Hépatite cytolytique · Hépatite virale C · Hépatite médicamenteuse · Toxicité hépatiqueAbstract Allopurinol is a drug indicated for the treatment of hyperuricemia. Its hepatic toxicity is rare. This is a case report about acute cytolytic hepatitis caused by allopurinol in a 65-year-old patient undergoing dual therapy for hepatitis C.
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