RT Journal Article SR Electronic T1 Extrapulmonary sarcoidosis primarily presenting as cholestatic liver disease JF BMJ Case Reports JO BMJ Case Reports FD BMJ Publishing Group Ltd SP e232618 DO 10.1136/bcr-2019-232618 VO 12 IS 12 A1 Pieter De Mulder A1 Bert Maertens A1 Anne Hoorens A1 An Vonck YR 2019 UL http://casereports.bmj.com/content/12/12/e232618.abstract 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.