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      Late-onset sarcoidosis after liver transplantation for primary biliary cirrhosis.

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          Abstract

          Primary biliary cirrhosis (PBC) and systemic sarcoidosis are granulomatous diseases of unknown etiology whose hepatic manifestations may infrequently be imitative of one another. Described herein is the first reported case in the medical literature of systemic sarcoidosis developing after liver transplantation for PBC. The presented patient, who suffered from typical clinical, laboratory, and pathologic manifestations of PBC, developed decompensated liver cirrhosis within a course of 8 years, necessitating orthotopic liver transplantation. A year and a half after transplantation, the patient developed diffuse, biopsy-proven, dermatologic and pulmonary manifestations of systemic sarcoidosis, which promptly responded to corticosteroid treatment. In retrospect, the patient's longstanding liver disease was probably caused by an unrecognizable, isolated hepatic form of sarcoidosis or an overlap between PBC and sarcoidosis. This patient illustrates the complexity that may be rarely encountered in differentiating between PBC and hepatic sarcoidosis. Discussed are the clinical, laboratory, and pathologic overlaps between hepatic sarcoidosis and PBC, and clues that may aid in the diagnosis and differentiation between the 2 disorders. Hepatologists and liver transplantation specialists should be aware of the rare possibility of hepatic sarcoidosis imitating PBC, and exacerbating systemically after liver transplantation.

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          Author and article information

          Journal
          J. Clin. Gastroenterol.
          Journal of clinical gastroenterology
          Ovid Technologies (Wolters Kluwer Health)
          0192-0790
          0192-0790
          Mar 2007
          : 41
          : 3
          Affiliations
          [1 ] Departments of Medicine, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
          Article
          00004836-200703000-00019
          10.1097/01.mcg.0000212653.51397.f6
          17426476
          2d96c84f-6fee-48ea-bc0b-803dce09110a
          History

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