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Annals of Gastroenterology
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2007 (EL)
Liver granulomatosis (EN)

Soultati, Aspasia
Dourakis, S.

Granulomas of the liver are circumscribed focal lesions (size from 50 to 300 mm) composed of epithelioid cells, varied numbers of mononuclear cells, multinucleated giant cells and other inflammatory cells. They represent a specialized, cell-mediated immune response to a wide variety of etiological antigenic stimulation, infectious and non-infectious or sequestration of a foreign indigestible, inorganic particle within macrophages. The causes of hepatic granulomas are numerous, and their identification can be difficult. The wide variety of etiologic factors includes primary biliary cirrhosis, sarcoidosis, drugs, hepatitis viruses, Hodgkin and non-Hodgkin lymphomas, tuberculosis, and other miscellaneous causes. Sarcoidosis is the main cause. Idiopathic cryptogenic granulomatous hepatitis is a poorly defined term characterized by a febrile illness with systemic signs and symptoms such as fatigue, sweating, shivering, hepatomegaly and/or splenomegaly, and abnormalities in serum liver tests (aminotransferase, alkaline phosphatase). In granulomatous hepatitis, granulomas are found exclusively in the liver and should not be used as an equivalent term for hepatic granulomas. Hepatic granulomas are typically asymptomatic. Constitutional symptoms such as fever, weight loss, anorexia and night sweats are often manifestations of the underlying disease. The recommended evaluation to establish the underlying cause of hepatic granulomas depends on the patientÂ’s clinical status, co-existing diseases and exposure history. Liver biopsy provides diagnosis in approximately 15-30% of cases. In almost one third of cases it is impossible to reach aetiological diagnosis on histological criteria alone. Key words: granuloma, granulomatous hepatitis, sarcoidosis, drug induced hepatitis, tuberculosis (EN)

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Ελληνική Γαστροεντερολογική Εταιρία (EL)
Hellenic Society of Gastroenterology (EN)

2007-03-19


Hellenic Society of Gastroenterology (EN)

1792-7463
1108-7471
Annals of Gastroenterology; Volume 17, No 4 (2004) (EN)



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