Hepatic, Splenic, and Gastrointestinal Involvement with Sarcoidosis

Judson, Marc A.

doi:10.1055/s-2002-36517

Cited by 92 publications

(86 citation statements)

References 78 publications

(203 reference statements)

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“…It has been reported in 50%-79% of patients by biopsy, and 67%-70% in autopsy series (7). Despite this common hepatic involvement, the frequency of liver function test abnormalities is about 35% (8). Liver biopsy is the only way to make a definitive diagnosis of hepatic involvement (4).…”

Section: Liver and Biliary Tractmentioning

confidence: 99%

Abdominal sarcoidosis: cross-sectional imaging findings

Gezer¹,

Başara²,

Altay³

et al. 2015

Diagn Interv Radiol

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Sarcoidosis is a multisystem inflammatory disease of unknown etiology. The lungs and the lymphoid system are the most commonly involved organs. Extrapulmonary involvement is reported in 30% of patients, and the abdomen is the most common extrapulmonary site with a frequency of 50%-70%. Although intra-abdominal sarcoidosis is usually asymptomatic, its presence may affect the prognosis and treatment options. The lesions are less characteristic and may mimick neoplastic or infectious diseases such as lymphoma, diffuse metastasis, and granulomatous inflammation. The liver and spleen are the most common abdominal sites of involvement. Sarcoidosis of the gastrointestinal system, pancreas, and kidneys are extremely rare. Adenopathy which is most commonly found in the porta hepatis, exudative ascites, and multiple granulomatous nodules studding the peritoneum are the reported manifestations of abdominal sarcoidosis. Since abdominal sarcoidosis is less common and long-standing, unrecognized disease can result in significant morbidity and mortality. Imaging contributes to diagnosis and management of intra-abdominal sarcoidosis. In this report we reviewed the cross-sectional imaging findings of hepatobiliary, gastrointestinal, and genitourinary sarcoidosis.

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Section: Liver and Biliary Tractmentioning

confidence: 99%

Abdominal sarcoidosis: cross-sectional imaging findings

Gezer¹,

Başara²,

Altay³

et al. 2015

Diagn Interv Radiol

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“…The organ is usually homogeneous, but multiple low-attenuating nodular lesions are occasionally noted and easily mistaken for lymphoma, metastases or infections [13,15,19]. Isolated or predominant hepatic nodular disease is less common than spleen impairement [2,5,13]. Besides spleen involvement, our patient presented also a hepatic nodule.…”

Section: Discussionmentioning

confidence: 66%

Unusual Presentation Of Sarcoidosis: Case Report

Tatiana

Mazilu

Crăciun

et al. 2017

ARS Medica Tomitana

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Sarcoidosis is a multisystem granulomatous disease with polymorphic manifestations, of unknown etiology, that can affect any organ in the body, but most commonly the lungs [1,2,3]. Extrapulmonary involvement is common, can occur in association with or in the absence of intrathoracic disease, and all organs can be involved, but it is rare to find an isolated extrapulmonary disease (less than 10% of patients) [3,4]. On occasion, the presentation of sarcoidosis may be atypical. We report a case of systemic sarcoidosis, with particular clinical data: extrathoracic onset with subdiaphragmatic lymph nodes, hepatomegaly and splenomegaly. Personal history and family history were insignificant.The onset was insidious, with two months prior this admission, with progressive weakness to which weight loss (10 kg) and nonspecific upper abdominal pain were associated later.His physical examination revealed only hepatomegaly and splenomegaly.Laboratory studies indicated biological inflammatory syndrome (ESR, slightly elevated fibrinogen), hypergammaglobulinemia and a negative tuberculin purified protein derivative (PPD ) skin test.Abdominal ultrasound and CT scan documented multiple subdiaphragmatic lymph nodes (periaortic, inter-aorto-caval and iliac), with diameter from 1.75 to 2.5 cm (Figure 1).

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“…Nearly 60% of patients with hepatic manifestations of sarcoidosis have constitutional symptoms such as fever, night sweats, anorexia, and weight loss. Liver involvement is at least twice as common in black Americans as in white Americans [44]. Portal hypertension with variceal bleeding, a hepatopulmonary syndrome with refractory hypoxemia, and cirrhosis leading to liver failure occur in only 1% of patients with sarcoidosis [45].…”

Section: Liver and Spleen Involvementmentioning

confidence: 99%

Sarcoidosis: Internal medicine perspective

Tınazlı

Bakhtiyarova

2016

J CLIN MED KAZ

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Sarcoidosis is a systemic autoimmune disease characterized by noncaseatinggranulomatous inflammation with unknown etiology.Although the lungs and respiratory system are most commonlyinvolved, sarcoidosis may involve virtually any part of the body,including the locomotor system, eyes, skin, lymph nodes. Diagnosis attained via consensus between the clinical presentation and natural history, pattern of major organ involvement, confirmatory biopsy, and response to therapy. Histopathological features remain the gold standard in diagnosis. Radiologic staging in sarcoidosis is based on the chest X-ray. If chest radiographis normal, high-resolution computed tomography (HRCT) can demonstrate pathological changes in a detailed manner. Sarcoidosis generally follows a benign course with occasional spontan remissions. The most important causes of mortality are acute and chronic respiratory failure, pulmonary hypertension and hemoptysis due to aspergillosis. When treatment is indicated, glucocorticoids remain the only recognized effective therapy for active sarcoidosis. Level of evidence for management of sarcoidosis is low, generally reflecting the results of limited number of clinical studies, case series and expert opinion. In selected cases, biological agents including, tumour necrosis factor inhibitors, seem to be promising.Keywords: Sarcoidosis -diagnosis -treatment. Тұжырымдама Саркоидоз, казеозды емес, гранулематозды қабынуымен сипатталатын этиологиясы белгісіз жүйелі аутоиммунды ауру. Өкпе және тыныс алу жүйесінің ең жиі зақымдалуына қарамастан, саркоидоз адам ағзасының кез келген бөлігін, соның ішінде тірек-қимыл жүйесі, көз, тері, лимфа түйіндерін қамтуы мүмкін. Диагноз клиникалық белгілері және шынайы ауру тарихы, ірі мүше зақымдауын растайтын биопсия-сымен, терапияға жауап беру консенсус арқылықоюлуда. Гистопатологиялық ерекшеліктері диагностикада алтын стандарт болып қалуда. Рентгенологиялық зерттеуде кеуде қуысы рентгенографиялық тұрғыдан қалыпты болса, ажыратымдылығы жоғары компьютерлік томогра-фия (HRCT) арқылы егжей-тегжейлі түрде патологиялық өзгерістерін көрсете алады. Саркоидоз, әдетте зарарсыз ағымды, кездейсоқ кенет-тен ремиссиясы кездесетін ауру. Өлімнің ең маңызды себептері жедел және созылмалы тыныс жетіспеушілігі, өкпелік гипертензия, аспер-гиллез салдарынан қан құсу болып табылады. Саркоидоздың белсенді түрінде ең тиімді сапалы ем глюкокортикоидтар болып табылады. Саркоидозды бақылау және басқару үшін дәлелдемелер деңгейінің төмендігін, әдетте, клиникалық зерттеулер, бақылау серияларының және сараптамалық қорытынды саны шектеулі нәтижелерін көрсетеді. Таңдалған жағдайларда ісіктердің некроздық фактор ингибиторлары, оған қоса алғанда, биологиялық агенттері перспективалы болып көрінеді. J Clin Med Kaz 2016; 3(41):6-13Маңызды сөздер: саркоидоз -диагностикасы -емі.Саркоидоз: взгляд терапевта тыназлы М., Бахтиярова г.Клиника Ближневосточного университета, медицинский факультет, кафедра Внутренних болезней, Никосия РезюмеСаркоидоз представляет собой системное аутоиммунное заболевание, характеризу...

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Hepatic, Splenic, and Gastrointestinal Involvement with Sarcoidosis

Cited by 92 publications

References 78 publications

Abdominal sarcoidosis: cross-sectional imaging findings

Abdominal sarcoidosis: cross-sectional imaging findings

Unusual Presentation Of Sarcoidosis: Case Report

Sarcoidosis: Internal medicine perspective

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