Granulomatous hepatitis of unknown etiology

Porphyria cutanea tarda and sarcoidosis

“…In our case, the chest X-ray changes, pulmonary function tests and positive Kveim test all support the diagnosis of sarcoidosis. Hepatic dysfunction (Elder, Gray & Nicholson, 1972;Grossman et ah, 1979) and hepatomegaly (Elder et al, 1972) are common in porphyria cutanea tarda, but hepatic dysfunction is unusual in sarcoidosis (Guckian & Perry, 1968;Scadding, 1967). We interpret the return to normal ofthe hepatic function together with the resolution ofthe hepatomegaly in our case as due to the action of prednisolone on the hepatic sarcoidosis.…”

Idiopathic granulomatous hepatitis and abdominal pain

“…Similarly Simon and Wolff (1973) mention that 6 out of 13 patients with pyrexia and granulomatous hepatitis had abdominal pain, predominantly affecting the right upper quadrant. Guckian and Perry (1966) in an analysis of cases noted abdominal pain in 33°% of patients with granulomatous hepatitis due to sarcoidosis or tuberculosis, but in only 8% with the idiopathic variety-on later investigations of these, Guckian and Perry (1968) often found a cause.…”

Diagnosis of Hepatic Granulomas: A Review1

“…If these patients are kept under regular medical review then a clear diagnosis can be made in a substantial number of cases (Guckian & Perry 1968, Cunningham et al 1982. In the latter study 17 patients were followed up and single examples of the following conditions were subsequently diagnosed: tuberculosis, sarcoidosis, primary biliary cirrhosis, ulcerative colitis, carcinoma of rectum, hepatoma, alpha-l-antitrypsin deficiency and pulmonary fibrosis, Kveim-negative pulmonary fibrosis, gallstones, rheumatic heart disease and one death from mesenteric artery thrombosis.…”