Portal Hypertension In Hepatic Sarcoidosis

Clinical manifestations of sarcoid liver disease

“…The average portal pressure was 337 mm of water (24.6 mmHg). Fifteen patients had abnormal liver function tests, 3,4,15,16,31,33,35,36,38 especially elevation of alkaline phosphatase. Alkaline phosphatase was 2‐50 times higher than normal values.…”

“…The average duration between the diagnosis of sarcoidosis and portal hypertension was 5.7 years. Majority of the patients were treated with splenectomy or portocaval shunts which caused reduction of the portal pressure 2,14,15 , 28–31,36 , 38 . Glucocorticoids led to little or no improvement in biochemical values and had no influence on portal hypertension or cirrhosis.…”

“…1 Since then, by 2001 an additional 35 patients with sarcoidosis and portal hypertension have been reported in the English medical literature. [1][2][3][4]14,[28][29][30][31][32][33][34][35][36][37][38][39] Among them, 20 patients had histological evidence of cirrhosis [2][3][4]15,16,31,35,37 and 16 patients had portal hypertension without cirrhosis. 2,14,[28][29][30][31][32][33][34]36,38,39 In one case, the results of the liver biopsy were not known.…”

“…More clinical characteristics of the patients are shown in Table 1. [1][2][3][4][14][15][16][28][29][30][31][32][33][34][35][36][37][38][39] Because there can be reasons other than portal hypertension for ascites and splenomegaly in patients with sarcoidosis, the diagnosis of portal hypertension was made according to direct measurement of pressure in branches of the portal vein in 18 patients, 1,4,14,[28][29][30][31][32][33] or according to the finding of esophageal vertices. All the patients had esophageal varices and nearly half had bleeding varices.…”

Hepatic Sarcoidosis

“…78 It is not clear how portal hypertension developed in those cases in which it has been reported, including those herein. 15,22,23,44,52,59 There has been no distinct correlation between fibrosis and elevation of portal venous pressure, but the total number of cases for study has been small. Extensive fibrosis was present in 3 of the cases re¬ ported here (Figs.…”