Cirrhosis due to hepatic sarcoidosis: A rare presentation

TL;DR

A rare case of cirrhosis caused by hepatic sarcoidosis highlights the need for thorough evaluation in cryptogenic cirrhosis.

Contribution

Presents a rare case linking sarcoidosis to cirrhosis and emphasizes its diagnostic challenges.

Findings

Sarcoidosis can present as cryptogenic cirrhosis with noncaseating granulomatous inflammation in the liver.

Elevated ACE levels and atypical enzyme patterns may indicate sarcoidosis in cirrhosis cases.

Oral steroids showed slight improvement in liver function in this patient.

Abstract

Sarcoidosis, although predominantly affecting the lungs, can present with cirrhosis, posing diagnostic challenges. Elevated ACE levels and atypical liver enzyme patterns should prompt consideration of sarcoidosis in cryptogenic cirrhosis cases, necessitating comprehensive evaluation including liver biopsy and imaging for accurate diagnosis and timely management.

Sarcoidosis is a systemic disease that can affect various organs, leading to a diverse range of clinical manifestations that make diagnosis challenging. Here, we present a case of sarcoidosis in a middle‐aged male who presented with cirrhosis. The cause of cirrhosis remained unknown for 4 years until the development of lymphadenopathy and ground‐glass opacities on lung imaging. A liver biopsy was performed, which revealed noncaseating granulomatous inflammation, thereby identifying sarcoidosis as the cause of cirrhosis. The patient was treated with oral steroids, which slightly improved his liver function over a short period. Given the diverse presentations of sarcoidosis, it should be considered as a possible differential diagnosis in cases of cryptogenic cirrhosis.

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