Management of Hepatic Sarcoidosis

Authors

  • Janina Sollors Department of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Bernhard Schlevogt Department of Medicine B, University Medical Center, Münster, Germany
  • Hartmut J Schmidt Department of Medicine B, University Medical Center, Münster, Germany
  • Marcus Alexander Woerns Department of Internal Medicine I, University Medical Center, Mainz, Germany
  • Peter R Galle Department of Internal Medicine I, University Medical Center, Mainz, Germany
  • Yuquan Qian Department of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Christoph Antoni Department of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Cleo-Aron Weis Department of Pathology, University Medical Center Mannheim, Germany
  • Svetlana Hetjens Department of Medical Statistics and Biomathematics, Heinrich- Lanz Center for Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Raoul Bergner Division of Rheumatology, Department of Medicine A, Ludwigshafen Medical Center, Ludwigshafen, Germany
  • Matthias P Ebert Department of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim; Clinical Cooperation Unit Healthy Metabolism, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
  • Andreas Teufel Department of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim; Clinical Cooperation Unit Healthy Metabolism, Center for Preventive Medicine and Digital Health, Medical Faculty Mannheim, Heidelberg University, Mannheim; Department of Internal Medicine II, Division of Hepatology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany

DOI:

https://doi.org/10.15403/jgld-4122

Keywords:

sarcoidosis, liver, hepatic sarcoidosis, diagnosis, treatment

Abstract

Background and Aims: Liver involvement in sarcoidosis may occur in up to 60% of all patients. As many patients experience only minor symptoms, a high number of undiagnosed cases must be assumed. In order to successfully identify patients with hepatic sarcoidosis, a throughout characterization of these patients and their course of disease is necessary.

Methods: We collected 40 patients from four German centers to evaluate current treatment standards and course of disease. All of our patients underwent liver biopsy with histologically proven granulomatous hepatitis.

Results: Detailed characterization of our patients showed an overall benign course of disease. Treatment was very diverse with glucocorticoids for 1 year in 55% (22/40), 5-10 years in 18% (7/40), and permanently in 18% (7/40). Other treatments included disease-modifying anti-rheumatic drugs (DMARDs), the conventional non-biological type in 53% of all patients (of these 81% received azathioprine, 46% metotrexate, 10% hydroxychloroquine, 10% mycophenolate mofetil and 10% cyclophosphamide and biologicals in 8%. Despite these very diverse treatments, patients generally showed slow progression of the disease. Two patients died. None of our patients received a liver transplantation.

Conclusions: Patients received diverse treatments and generally showed slow progression of the disease. Based on our experience, we proposed a diagnostic work up and surveillance strategy as a basis for future, prospective register studies.

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Published

2022-09-15

How to Cite

1.
Sollors J, Schlevogt B, Schmidt HJ, Woerns MA, Galle PR, Qian Y, Antoni C, Weis C-A, Hetjens S, Bergner R, Ebert MP, Teufel A. Management of Hepatic Sarcoidosis. JGLD [Internet]. 2022 Sep. 15 [cited 2025 Aug. 9];31(3):323-30. Available from: https://www.jgld.ro/jgld/index.php/jgld/article/view/4122

Issue

Vol. 31 No. 3: September 2022

Section

Original Article