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Hepatic and gastrointestinal sarcoidosis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Hepatic or gastrointestinal involvement can be seen in around 18% of patients with sarcoidosis (1).

Liver involvement

  • hepatic granulomas can be found in about 60% - 80% of liver biopsy specimens of patients with sarcoidosis (2). They are more common in patients with bilateral hilar lymphadenopathy alone rather than BHL plus pulmonary infiltrates
  • usually clinically silent, may have constitutional symptoms such as fever, night sweats, anorexia, and weight loss. Liver enlargement is far less frequent (2,3)
  • elevated serum aminotransferase and alkaline phosphatase levels are seen in around 10% of sarcoidosis patients (2)
  • chronic intrahepatic cholestasis, hepatic dysfunction, cirrhosis and portal hypertension are extremely rare and severe complications of sarcoidosis (3)

Gastrointestinal tract

  • gastrointestinal involvement is seen in less than 1% of patients
  • stomach is the most involved part (3), gastric symptoms are uncommon. Granulomas are sometimes reported as incidental findings at post mortem in the stomach
  • small intestine and colon sarcoidosis is uncommon but if present may mimic Crohn’s disease (3)
  • splenic involvement presents with splenomegaly which is usually minimal and asymptomatic (3).

Reference:

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