What can be hidden under the mask of unspecified hepatitis: a clinical observation and a literature review

Background. Sarcoidosis is an immunoinflammatory multisystem disease of unknown etiology. In sarcoidosis, the lungs are most commonly affected, while the liver is the third most commonly affected organ in a systemic process. Isolated liver damage is rare. The diagnosis of hepatic sarcoidosis (HS) is difficult, most cases of liver damage in sarcoidosis are clinically asymptomatic, extremely rarely patients develop icterus, chronic cholestasis, portal hypertension (PH) without cirrhotic transformation. In this case, the diagnosis of HS depends on the histological evaluation. Description of the clinical case. We present a clinical case of HS complicated by non-cirrhotic PH. There are not many reports of PH complicating HS. An important aspect that attracts attention is the complex pathogenesis of sarcoidosis, the presence of non-cirrhotic PH in a patient with HS without cirrhosis, and as fibrosis progresses, the possibility of increasing pressure in the portal vein system, so PH will be mixed etiology. Conclusion. The purpose of the publication of our clinical observation is drawing the attention of practitioners, gastroenterologists to the problem of the inadmissibility of the existence of a diagnosis of «unspecified hepatitis», the need to verify the diagnosis by all possible methods already at the first visit of the patient.

hepatic sarcoidosis, portal hypertension, unspecified hepatitis