Granulomatous hepatitis in a patient with Crohn's disease and cholestasis.
Citation: BMJ Case Reports. 2017, 2017 Sep 07PMID: 28882937Institution: MedStar Washington Hospital CenterDepartment: Medicine/Internal MedicineForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *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 AdultYear: 2017ISSN:- 1757-790X
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Journal Article | MedStar Authors Catalog | Article | 28882937 | Available | 28882937 |
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.
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