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Bécheur, Hakim; Dall'Osto, Hélène; Châtellier, Gilles; Charton-Bain, Marie-Clotilde; Aubertin, Jean-Marc; Attar, Alain; Bloch, Francis; Petite, J P

doi:10.1023/a:1018816214640

Cited by 30 publications

(3 citation statements)

References 11 publications

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“…It also helps to modulate the immune response by decreasing HLA class I and class II antigens on the cell membranes of the hepatic and bile duct epithelial cells, respectively. 53 Recent studies have shown a beneficial effect of this agent in the treatment of hepatic sarcoidosis, especially when patients with cholestasis are symptomatic with pruritus. 49 It has the potential effect of delaying the progression of the disease.…”

Section: Ursodeoxycholic Acidmentioning

confidence: 99%

Hepatic Sarcoidosis

Tadros

Forouhar

2016

JCTH

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Sarcoidosis is a multisystem disease characterized by the presence of non-caseating granulomas in affected organs. Pulmonary involvement is the most common site of disease activity. However, hepatic involvement is also common in sarcoidosis, occurring in up to 70% of patients. Most patients with liver involvement are asymptomatic. Therefore, the majority of cases are discovered incidentally, frequently by the finding of elevated liver enzymes. Pain in the right upper quadrant of the abdomen, fatigue, pruritus, and jaundice may be associated with liver involvement. Portal hypertension and cirrhosis are complications linked to long-standing hepatic sarcoidosis. Liver biopsy is usually required to confirm the diagnosis. It is important to differentiate hepatic sarcoidosis from other autoimmune and granulomatous liver diseases. Not all cases of hepatic sarcoidosis require treatment. For symptomatic patients, the first line treatment includes corticosteroids or ursodeoxycholic acid. Various immunosuppressant agents can be used as second line agents. Rarely, severe cases require liver transplantation.

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Section: Ursodeoxycholic Acidmentioning

confidence: 99%

Hepatic Sarcoidosis

Tadros

Forouhar

2016

JCTH

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“…Steroid-sparing agents have been used with some success, and agents such as MTX, AZA, antimalarials, and ursodeoxycholic acid all have been used 109. The latter has been used in patients presenting with signs of cholestatic jaundice 110,111. AZA is preferred over MTX by some, although both are potentially hepatotoxic 107…”

Section: Extrapulmonary Disease Manifestationsmentioning

confidence: 99%

Management of extrapulmonary sarcoidosis: challenges and solutions

Al-Kofahi¹,

Korsten²,

Ascoli³

et al. 2016

TCRM

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BackgroundSarcoidosis is a chronic multisystem disease of unknown etiology characterized by noncaseating granulomas that most often involves the lungs, but frequently has extrapulmonary manifestations, which might be difficult to treat in individual patients.ObjectiveTo review different disease manifestations, focusing on extrapulmonary organ systems, and to provide treatment options for refractory cases.Materials and methodsWe performed a literature search using Medline and Google Scholar for individual or combined keywords of “sarcoidosis, extrapulmonary, treatment, kidney, neurosarcoidosis, cardiovascular, gastrointestinal, transplantation, musculoskeletal, rheumatology, arthritis, and skin”. Peer-reviewed articles, including review articles, clinical trials, observational trials, and case reports that were published in English were included. References from retrieved articles were also manually searched for relevant articles.Results and conclusionIsolated involvement of a single organ or organ system is rare in sarcoidosis, and thus all patients must be thoroughly evaluated for additional disease manifestations. Cardiac sarcoidosis and neurosarcoidosis may be life-threatening. Clinicians need to assess patients comprehensively using clinical, laboratory, imaging, and histopathological data to recommend competently the best and least toxic treatment option for the individual patient.

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“…Treatment with ursodeoxycholic acid, a naturally occurring bile acid, has been suggested to reduce symptoms and biochemical abnormalities of cholestasis in patients with hepatic sarcoidosis. 113–115 …”

Section: Treatmentmentioning

confidence: 99%