Sarcoidosis manifesting with abnormalities in hepatic function : 3 cases

Abstract

Three patients with previously undiagnosed sarcoidosis presented with abnormalities of hepatic function and hepatomegaly in two, and erythema nodosum in the third. The latter patient had abnormal circulating liver enzymes. The other manifestations included lymphadenopathy, skin lesions, arthropathy, hypercalcaemia and pulmonary fibrosis. The histological and biochemical evaluation of these patients confirmed the clinical suspicion of sarcoidosis. Liver biopsy showed multiple non-caseating granulomas in one and a focal, marked, lymphocytic infiltrate in the liver parenchyma, as well as sinusoidal dilatation in another. These features are consistent with the manifestations of sarcoidosis in the liver that have been reported in the literature.