Clinical Characteristics and Outcome of Hepatic Sarcoidosis: A Population-Based Study 1976-2013

被引:47
作者
Ungprasert, Patompong [1 ,2 ]
Crowson, Cynthia S. [1 ,3 ]
Simonetto, Douglas A. [4 ]
Matteson, Eric L. [1 ,5 ]
机构
[1] Mayo Clin, Coll Med & Sci, Dept Internal Med, Div Rheumatol, 200 First Ave SW, Rochester, MN 55905 USA
[2] Mahidol Univ, Siriraj Hosp, Dept Med, Div Rheumatol, Bangkok, Thailand
[3] Mayo Clin, Coll Med & Sci, Dept Hlth Sci Res, Div Biomed Stat & Informat, Rochester, MN USA
[4] Mayo Clin, Coll Med & Sci, Dept Internal Med, Div Gastroenterol & Hepatol, Rochester, MN USA
[5] Mayo Clin, Coll Med & Sci, Dept Hlth Sci Res, Div Epidemiol, Rochester, MN USA
基金
美国国家卫生研究院;
关键词
ANGIOTENSIN-CONVERTING ENZYME; PULMONARY SARCOIDOSIS; UNITED-STATES; EPIDEMIOLOGY; JAPAN; INVOLVEMENT; HISTORY; COHORT; HEALTH; 5-YEAR;
D O I
10.1038/ajg.2017.231
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
OBJECTIVES: Data on clinical manifestations and outcome of hepatic sarcoidosis are scarce. This study aimed to use a population-based cohort of patients with incident sarcoidosis to better describe the characteristics of hepatic sarcoidosis. METHODS: A cohort of incident cases of sarcoidosis in Olmsted County, MN, USA, from 1976 to 2013 was identified from the database. Diagnosis was verified by individual medical record review. Confirmed cases of sarcoidosis were then reviewed for liver involvement. Data on clinical manifestations, imaging study, liver biochemical tests, treatment, and outcome were collected. Cumulative incidence of cirrhosis adjusted for the competing risk of death was estimated. RESULTS: A total of 345 cases of incident sarcoidosis were identified. Of these, 19 cases (6%) had liver involvement (mean age 46.1 years, 53% female and 79% Caucasian). Most patients had asymptomatic liver disease and were discovered in pursuit of abnormal biochemical tests and imaging studies. Alkaline phosphatase (ALP) and gamma-glutamyl transferase (GGT) were elevated in the majority of patients (88 and 90%, respectively). Elevated transaminases were less common and less severe. About half of patients had abnormal imaging study with hypodense nodular lesions being the most common abnormality (six patients) followed by hepatomegaly (three patients). Liver biopsy revealed non-caseating granuloma in 88% (14 of 16 patients). A total of four patients developed cirrhosis. CONCLUSIONS: Involvement of the liver by sarcoidosis was seen in 6% of patients with sarcoidosis. The majority of patients were asymptomatic. Elevated ALP and GGT were the most common abnormal biochemical tests. Liver biopsy revealed non-caseating granuloma in almost all cases. Cirrhosis was seen in a significant number of patients. Generalizability of the observations to other populations may be limited, as the studied population was predominantly Caucasian. The prevalence of liver disease may be higher in more diverse populations.
引用
收藏
页码:1556 / 1563
页数:8
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