A Case of Granulomatous Hepatitis Associated with Common Variable Immunodeficiency.
- Author:
Tae Hoon OH
1
;
Han Chu LEE
;
Tae Yoon LEE
;
Byung Cheol SONG
;
Young Hwa CHUNG
;
Yung Sang LEE
;
Eun Sil YU
;
Dong Jin SUH
Author Information
1. Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. hch@www.amc.seoul.kr
- Publication Type:Case Report
- Keywords:
Common variable immunodeficiency;
Hepatitis/Granulomatous hepatitis
- MeSH:
Agammaglobulinemia;
Alkaline Phosphatase;
Bacillus;
Biopsy;
Common Variable Immunodeficiency*;
Diagnosis;
Diagnosis, Differential;
Female;
Granuloma;
Hepatitis*;
Humans;
Immunoglobulins;
Inflammation;
Liver;
Liver Cirrhosis;
Liver Diseases;
Necrosis;
Otitis Media;
Phagocytes;
Sarcoidosis;
Tuberculosis;
Young Adult
- From:The Korean Journal of Hepatology
2001;7(1):95-99
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A granuloma is a compact, organized collection of chronic inflammatory cells, predominantly consisting of mature mononuclear phagocytes. Clinical manifestations of hepatic granulomas vary widely from asymptomatic elevation of serum alkaline phosphatase activity to liver cirrhosis. The hepatic granuloma is nonspecific and represents a pathologic reaction induced by any of a number of factors. Although the causes of hepatic granuloma vary considerably according to geographic site, sarcoidosis and tuberculosis are the two leading causes. Here we present a 20-year-old female with a long history of recurrent otitis media, upper respiratory infection, and unexplained hepatosplenomegaly. A diagnosis of common variable immunodeficiency was made, based on the decreased levels of serum immunoglobulins. A liver biopsy revealed chronic granulomatous inflammation, but neither caseous necrosis nor acid-fast bacillus was found. Her liver disease progressed despite a nine-month course of antituberculous medication. Hypogammaglobulinemia should be included in the differential diagnosis of granulomatous liver disease.
