BMJ Case Reports 2017; doi:10.1136/bcr-2017-220988
  • Unusual association of diseases/symptoms

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

  1. Amit P Pathak2
  1. 1Department of Medicine, Georgetown University School of Medicine, Washington, DC, USA
  2. 2Department of Internal Medicine, MedStar Washington Hospital Center, Washington, DC, USA
  1. Correspondence to Dr Bogdan Ioannis Patedakis Litvinov, bip3{at}
  • Accepted 24 August 2017
  • Published 7 September 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.


  • Contributors Both authors have contributed equally to this work, including reviewing the patient's medical records, researching relevant medical literature, and preparing and editing the manuscript. The corresponding author obtained the patient's informed consent.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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