Granulomatous liver involvement in a child with systemic lupus erythematosus: a case report and review of the literature

Abstract

Systemic lupus erythematosus (SLE) is uncommon in young children and unusual in infancy. Although a variety of liver pathologies have been reported in SLE, presentation of this disease with granulomatous liver involvement is very rare. In this article, for the first time, we report an infant girl presenting with unexplained hepatosplenomegaly and non-necrotizing granulomatous liver involvement at the age of six months who later developed pancytopenia and proteinuria and was finally diagnosed with SLE at the age of three years. Therefore, we suggest that SLE could be considered as one of the possible differential diagnoses when infants or children present with unexplained granulomatous liver involvement.

Common symptoms for a rare disease in a girl with sarcoidosis: a case report

“…Infections are the prevalent underlying aetiology of granulomas: tuberculosis, toxoplasmosis, leishmaniosis, syphilis, brucellosis, fungal (Blastomycosis, cryptococcosis, histoplasmosis), and viral hepatitis (Hepatitis C, CMV, EBV) are the most common causes [ 13 ]. Among non-infectious diseases, we can consider neoplasm, adverse drug reactions, and systemic autoimmune disorders; while chronic granulomatous disease of childhood, Kikuchi’s disease and Melkersson-Rosenthal Syndrome are unusual causes [ 13 – 15 ] (Table 1 ). In the Western world, sarcoidosis and tuberculosis are the two major causes of granulomas [ 16 ].…”

“…However, sarcoidosis remains an enigmatic disease with high variability in extent, severity and long-term outcome. At present there is no curative treatment regimen and, since a large percentage of cases have a self-limiting course (with spontaneous remission in few years), treatment should be administered with caution [ 15 , 18 , 19 ]. Corticosteroids are the first-line therapy; second-line drugs include different alternatives such as methotrexate, TNFα-antagonists, cyclophosphamide, mycophenolate mofetil (MMF) and tacrolimus.…”