ABSTRACT
A minority of patients with sarcoidosis show clinically
evident involvement of the liver, although both biopsy and
necropsy studies usually show that the liver contains
granulomas. Clinically significant hepatic dysfunction is
rare, but up to one-third of patients have hepatomegaly or
a cholestatic pattern of deranged liver function, with minimal
change in aminotransferase levels. Typically this mild
derangement in liver parameters is asymptomatic; however,
hepatic sarcoid has been associated with recognized clinical
syndromes, such as portal hypertension, chronic intrahepatic
cholestasis, and even BuddChiari syndrome. Such a clinical presentation in a patient in whom the diagnosis of sarcoi-
dosis was not readily evident, from involvement of other
organs, would require the exclusion of a wide range of liver
diseases where granulomatous changes can also be present on
liver histology.
