Hepatic sarcoidosis in patients presenting with liver dysfunction: imaging appearance, pathological correlation and disease evolution.
Objectives: We hypothesize that hepatic sarcoidosis is a dynamic process that can lead to cirrhosis and portal hypertension, independent of the course of thoracic disease. Therefore, we assess the imaging appearance and progression of hepatic sarcoidosis in subjects presenting with hepatic dysfuncti...
| Publicado en: | European Radiology Vol. 26; no. 9; pp. 3129 - 3138 |
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| Autores principales: | , , , , , , , |
| Formato: | diagnostic images research tables/charts Journal Article |
| Publicado: |
Springer Nature
Sep2016
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=117171301&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 117171301 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Sep2016 vid: 26 iid: 9 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 117171301 117171301 NLM26780641 117171301 10.1007/s00330-015-4169-2 NLM26780641 117171301 ppf: 3129 ppct: 9 formats: fmt: @attributes: type: P tig: atl: Hepatic sarcoidosis in patients presenting with liver dysfunction: imaging appearance, pathological correlation and disease evolution. aug: au: Fetzer, David Rees, Mitchell Dasyam, Anil Tublin, Mitchell Fetzer, David T Rees, Mitchell A Dasyam, Anil K Tublin, Mitchell E affil: Department of Radiology , UT Southwestern Medical Center , 5323 Harry Hines Blvd Dallas 75390-8896 USA sug: subj: Liver Diseases Diagnosis Magnetic Resonance Imaging Methods Multidetector Computed Tomography Methods Sarcoidosis Diagnosis Liver Middle Age Prospective Studies Disease Progression Liver Diseases Etiology Retrospective Design Female Aged Biopsy Male Sarcoidosis Complications Hypertension, Portal Pathology Adult Human Middle Aged: 45-64 years Aged: 65+ years Adult: 19-44 years Female Male ab: Objectives: We hypothesize that hepatic sarcoidosis is a dynamic process that can lead to cirrhosis and portal hypertension, independent of the course of thoracic disease. Therefore, we assess the imaging appearance and progression of hepatic sarcoidosis in subjects presenting with hepatic dysfunction.Methods: An IRB-approved, HIPAA-compliant, single-institution retrospective review identified 39 subjects with sarcoidosis-related liver dysfunction. Clinical information was collected. Two abdominal radiologists analyzed baseline and follow-up imaging studies, scoring features of cirrhosis. Chest CT was also analyzed.Results: At presentation, 23 subjects (59.0 %) exhibited >3 cirrhotic features and 15 (38.5 %) >2 findings of portal hypertension. Of subjects with available follow-up, 57.9 % (19 subjects; mean interval 4.7 years) showed worsening of >3 cirrhotic features (Pearson rho = 0.58; p = 0.009). Parenchymal nodules were uncommon (25.6 %), and most regressed. Although 87.2 % of subjects were diagnosed with thoracic sarcoidosis, there was poor correlation between severity of hepatic and chest disease (Pearson rho = 0.30; p = 0.119). A mean of 7.2 years elapsed between diagnosis of pulmonary and liver involvement.Conclusion: Sarcoidosis may present as liver dysfunction, cirrhosis or portal hypertension. Sarcoid-related liver disease may progress and can manifest without, alongside or significantly after a diagnosis of pulmonary disease.Key Points: • Patients often present with elevated liver function tests indicating cholestasis. • Patients may present with portal hypertension, and some progress to cirrhosis. • Though biopsy can be considered for focal liver lesions, most will regress. • Extent of intra-abdominal involvement may not correlate with severity of thoracic disease. • Liver disease may manifest alongside, prior to or significantly after initial diagnosis. pubtype: Academic Journal doctype: diagnostic images research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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