Granulomatous hepatitis in a patient with Crohn's disease and cholestasis. - 2017

We describe a case of a 23-year-old woman with a history of Crohn's disease (CD), who initially presented with sepsis-like symptoms, subsequently developed severe cholestasis and following extensive inpatient workup was found to have non-caseating granulomas on her liver biopsy. Infectious aetiologies were excluded and the patient was treated with oral corticosteroids, which ameliorated but did not completely reverse the cholestasis. We review the differential diagnosis of hepatic granulomas and discuss the potential difficulties in establishing their exact aetiology in patients with CD. Copyright (c) BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.


English

1757-790X


*Cholestasis/co [Complications]
*Crohn Disease/co [Complications]
*Granuloma/pa [Pathology]
*Hepatitis/pa [Pathology]
Administration, Oral
Adrenal Cortex Hormones/ad [Administration & Dosage]
Adrenal Cortex Hormones/tu [Therapeutic Use]
Cholangiopancreatography, Endoscopic Retrograde
Cholestasis/et [Etiology]
Crohn Disease/pa [Pathology]
Diagnosis, Differential
Female
Granuloma/dt [Drug Therapy]
Granuloma/et [Etiology]
Hepatitis/co [Complications]
Hepatitis/et [Etiology]
Humans
Liver/dg [Diagnostic Imaging]
Liver/pa [Pathology]
Treatment Outcome
Ultrasonography
Young Adult


MedStar Washington Hospital Center


Medicine/Internal Medicine


Journal Article