PT  - JOURNAL ARTICLE
AU  - Pieter De Mulder
AU  - Bert Maertens
AU  - Anne Hoorens
AU  - An Vonck
TI  - Extrapulmonary sarcoidosis primarily presenting as cholestatic liver disease
AID  - 10.1136/bcr-2019-232618
DP  - 2019 Dec 01
TA  - BMJ Case Reports
PG  - e232618
VI  - 12
IP  - 12
4099  - http://casereports.bmj.com/content/12/12/e232618.short
4100  - http://casereports.bmj.com/content/12/12/e232618.full
SO  - BMJ Case Reports2019 Dec 01; 12
AB  - Sarcoidosis is a multisystem inflammatory disorder associated with non-caseating granulomas in affected organs, most commonly the lungs. Involvement of extrapulmonary organs is common, but lack of pulmonary involvement is rare and is called non-pulmonary sarcoidosis (NPS). Like pulmonary sarcoidosis, a definitive diagnostic test for NPS does not exist. Instead, the diagnosis of sarcoidosis requires the following elements: clinical and radiographic manifestations of sarcoidosis, histopathological detection of non-caseating granulomas and the exclusion of other diseases that may present similarly. Because of the experience with corticosteroids in pulmonary sarcoidosis, they are generally considered first-line therapy for NPS too. Ursodeoxycholic acid can be used to reduce cholestasis in NPS, but is inferior to corticosteroids in reducing inflammation. We hereby present a case that is particularly notable for its rare presentation of NPS as a granulomatous hepatitis with cholestatic liver function tests.