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Affiliations
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
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Management of Hepatic Sarcoidosis
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.