Granulomatous Hepatitis

Harrington, P; Gutierrez, J. Jimenez; Ramírez-Ronda, C H; Quinones-Soto, R.; Bermúdez, Ramon H.; Chaffey, J.

doi:10.1093/clinids/4.3.638

Cited by 78 publications

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“…The positive rates for acid-fast bacilli and cultures of liver biopsy specimens have both been reported to range from 0% to 35%, 12 whereas the sensitivity of PCR in the diagnosis of hepatic granulomas has been reported to be 58%. 13 Therefore, the negative acid-fast bacilli and cultures did not exclude tuberculosis, demonstrating the need for combined clinical, histopathological, and PCR diagnoses to confi rm tuberculosis in this type of case.…”

Section: Discussionmentioning

confidence: 99%

Isolated tuberculous liver abscess invading the abdominal wall: Report of a case

et al. 2011

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Isolated tuberculous liver parenchymal and subcapsular abscesses are unusual,^but an abdominal wall abscess secondary to a tubercular liver abscess is extremely rare. To our knowledge, there is only one reported case of an abdominal wall abscess occurring secondary to a subcapsular liver abscess. We report the first documented case of direct invasion of the abdominal wall from an isolated tuberculous liver parenchymal abscess, diagnosed by imaging, surgical, and pathological findings. Although ultrasonography and computed tomography showed nonspecific hypoechoic and hypodense findings with peripheral contrast enhancement, T2-weighted magnetic resonance imaging (MRI) revealed a heterogeneous mass with characteristic hypointensity, suggesting the presence of free radicals produced by macrophages during active phagocytosis in tuberculosis. Although our case is extremely unusual, when hypointensity on T2-weighted MRI is seen, the possibility of tuberculosis should be considered and the results of polymerase chain reaction, culture, and histopathological diagnosis must be taken into account to avoid needless invasive surgery.

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Section: Discussionmentioning

confidence: 99%

Isolated tuberculous liver abscess invading the abdominal wall: Report of a case

et al. 2011

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“…[1][2][3][4][5][6][7] Hepatic granulomas may represent an infectious process, either primary or systemic; an adverse drug effect; a reaction to foreign material or nearby tumor; or have no clinical importance whatsoever. This review emphasizes infectious causes of granulomas but also includes some important noninfectious entities included in the differential diagnosis.…”

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confidence: 99%

Hepatic Granulomas: A Review With Emphasis on Infectious Causes

Lamps

2015

Archives of Pathology &Amp; Laboratory Medicine

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Context Many diseases that cause granulomas or granulomatous inflammation involve the liver. Some of these disease processes are intrinsic hepatic diseases, whereas others are disseminated systemic diseases that involve the liver as well as other organs. Objective To review the evaluation of granulomas in the liver with an emphasis on infectious causes, as well as the use of special stains, serologic studies, and molecular diagnostic techniques. Pertinent noninfectious causes of hepatic granulomas that are in the differential diagnosis are also discussed. Data Sources Literature review and cases acquired during years of practice. Conclusions A wide variety of infectious and noninfectious entities cause hepatic granulomas.

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“…Hepatic granuloma formation appears to represent a nonspecific reaction to stimulation by specific antigens, circulating or locally formed antigen antibody complexes, or foreign bodies. 33 It implies that immune mechanism may play a part in liver damage.…”

Section: Resultsmentioning

confidence: 99%

Hepatic injury during ketoconazole therapy in patients with onychomycosis: A controlled cohort study

Chien

1997

Hepatology

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duced hepatitis is often diagnosed by exclusion, so that the To evaluate the incidence, severity, and course of ketopossibility of hepatitis C virus (HCV) infection has not been conazole-associated hepatic injury, 211 patients with excluded in most reports, because serological markers for onychomycosis were randomized by a ratio of 2:1 to re-HCV were not available before 1989. 27 Therefore, we have ceive either ketoconazole (137 patients) or griseofulvin conducted this controlled, cohort study to examine the inci-(74 patients). All of them were seronegative for hepatitis dence, severity, and clinical course of ketoconazole-induced B surface antigen (HBsAg) and anti-hepatitis C virus hepatic injury. believed and that transient subclinical injury is muchFollow-up. After the start of ketoconazole or griseofulvin therapy, more common than overt hepatitis. Therapy with ketotests for serum AST and ALT were scheduled in all patients once conazole may be continued with caution in the absence every 2 weeks for the first 3 months, and at monthly intervals thereof symptoms and/or hyperbilirubinemia, but should be after during the course of therapy. After a serum AST or ALT elevadiscontinued if overt hepatitis occurs. (HEPATOLOGY tion was detected, patients were monitored closely with clinical 1997;25:103-107.) evaluation and weekly serum AST, ALT, alkaline phosphatase, gglutamyl transpeptidase, and bilirubin measurements until normalization. It was determined before the study that ketoconazole or Ketoconazole, an imidazole derivative, has been used griseofulvin was to be discontinued promptly if clinical symptoms of widely in the treatment of systemic fungal infections.1 Sevhepatitis or hyperbilirubinemia develeped. Complete blood cell leveral case reports of mild to severe hepatic injury, including els, its differential counts, and serological markers of hepatitis A icteric and fatal cases, have been published 2-26 with an esti-virus, B virus, delta virus, and HCV, as well as anti-nuclear antibody mated incidence of symptomatic hepatic injury of 1:15,000 to and anti-smooth muscle antibody titers, were also studied when ap-1:2,000. 15,16,18 In addition, the transient asymptomatic in-propriate. Liver biopsy was routinely advised when abnormal AST crease of serum transaminase has also been reported in some or ALT levels were detected, but was performed in only one patient patients 2,3,14,[20][21][22] HDV (anti-HD) were assayed using commercial radioimmunoassays North Chicago, IL). Anti-HCV was assayed using a second-genera- Received February 5, 1996; accepted August 16, 1996. tion enzyme immunoassay

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Granulomatous Hepatitis

Cited by 78 publications

References 0 publications

Isolated tuberculous liver abscess invading the abdominal wall: Report of a case

Isolated tuberculous liver abscess invading the abdominal wall: Report of a case

Hepatic Granulomas: A Review With Emphasis on Infectious Causes

Hepatic injury during ketoconazole therapy in patients with onychomycosis: A controlled cohort study

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