Izolovana sarkoidoza jetre

  • Ivana Jovičić Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
  • Dušan Dj. Popović Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
  • Ljubiša Tončev Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
  • Žikica Jovičić Clinic for Alergology and Immunology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Violeta Vučinić Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade Serbia
  • Nada Kovačević Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Srdjan Djuranović Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Ivan Boričić Institute of Pathology, Faculty of Medicine, University of Belgrade, Belgrade Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Marjan Micev Department for Histopathology of Clinic for Abdominal Surgery, Clinical Center of Serbia, Belgrade, Serbia
  • Milan Špuran Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
  • Tomica Milosavljević Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
DOI: https://doi.org/10.2298/2797
Ključne reči: sarcoidosis||, ||sarkoidoza, liver cirrhosis||, ||jetra, ciroza, splenomegaly||, ||splenomegalija, ascites||, ||ascit, diagnosis||, ||dijagnoza, histological techniques||, ||histološke tehnike, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Sarkoidoza je multisistemsko granulomatozno oboljenje nepoznate etiologije. Hepatični granulomi nalaze se kod 50–65% bolesnika sa sistemskom sarkoidozom, ali je izolovana hepatična sarkoidoza retka. Klinička slika varira od asimptomatske do manifestne. Dijagnoza se postavlja na osnovu karakterističnog patohistološkog nalaza. Prikaz bolesnika. Prikazan je muškarac, star 69 godina, primljen zbog oticanja trbuha i abdominalnih bolova. U laboratorijskim analizama imao je povišenje enzima holestaze, pancitopeniju i povišenje angiotenzin-konvertirajućeg enzima. Ultrasonografija i magnetna rezonanca abdomena ukazali su na cirozu jetre, splenomegaliju i ascites. Dijagnoza hepatične sarkoidoze potvrđena je patohistološkim pregledom bioptata jetre. Bolesnik je lečen kortikosteroidima. Nakon 18 meseci, bolesnik je bio bez tegoba, sa laboratorijskim i kliničkim poboljšanjem. Zaključak. Kod bolesnika sa hepatosplenomegalijom i poremećajima u hepatogramu, i kod onih bez simptoma, i onih sa simptomima oboljenja, u diferencijalnoj dijagnozi treba razmotriti izolovanu hepatičku sarkoidozu. Jedino pravovremena dijagnoza i adekvatna terapija mogu dovesti do subjektivnog i objektivnog poboljšanja.

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Objavljeno
2015/04/23
Broj časopisa
Vol. 71 Br. 4 (2014)
Rubrika
Prikaz bolesnika