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Query: UMLS:C0019158 (hepatitis)
 30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Granulomatous hepatitis is not a uniform disease entity but a generic histopathologic diagnosis. The present review of aetiology and epidemiology of granulomas in the liver, shows that in the past tuberculosis and sarcoidosis were the most frequent but there remained a large percentage of "undiagnosis" cases; at the present drug-induced granulomatous hepatitis are frequently reported and "undiagnosed cases" are rare. Analysis of the hystological features of the most common granulomas is presented.
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PMID:[Hepatic granulomatosis]. 668 32

The muramidase content of reactive cells in the lesions of human foreign body reactions, lepromatous and tuberculoid leprosy, sarcoidosis, tuberculosis, and granulomatous hepatitis, was assessed using specific anti-human muramidase antiserum and a peroxidase-anti-peroxidase marker system. Epithelioid and giant cells in sarcoidosis, tuberculosis, granulomatous hepatitis, and tuberculoid leprosy all showed the presence of muramidase in their cytoplasm. The muramidase content of macrophages in foreign body reactions and lepromatous leprosy varied and most multinucleate cells in these lesions gave a negative reaction. Possibly varying rates of muramidase secretion may account for these differences.
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PMID:Muramidase content of cells in human granulomatous reactions. 701 65

An unusual case of acute febrile illness clinically thought to be a manifestation of either granulomatous hepatitis or Hodgkin's disease is described. The spleen and enlarged periaortic lymph nodes at the level of the spleen revealed multiple noncaseating granulomas containing vacuoles and associated multinucleated giant cells. The lesions appeared to be consistent with lipogranulomas. The liver contained multiple noncaseating granulomas. The clinical history and analyses of tissue samples failed to document the presence of exogenous lipid. There was no evidence in support of a viral, fungal, or bacterial cause for any of the known granuloma-forming diseases. The patient recovered on steroid therapy and has remained well for one year following the onset of the acute illness. The possibility that this case represents lipogranulomatous pseudosarcoid of the spleen and periaortic lymph nodes or a variant of sarcoid cannot be excluded.
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PMID:Idiopathic lipogranulomatosis of spleen and periaortic lymph nodes with noncaseating granulomas of liver. 717 54

Granulomatous hepatitis is a generic histopathologic diagnosis seen in approximately 5 to 10% of liver biopsy specimens. In the past, tuberculosis and sarcoidosis have been most frequently incriminated, although numerous other infectious and noninfectious etiologies have been reported. We have studied 95 cases of granulomatous hepatitis representing 6% of 1500 liver biopsies performed over a period of 10 years. Although sarcoidosis accounted for approximately one-third of these cases, probable and possible associations with medicinal compounds were detected in 29%. Highly suspect drugs include antihypertensive, antirheumatic and analgesic, anticonvulsant, and antimicrobial agents, but any drug may act as a hapten by covalent binding with macromolecular protein. The morphologic features of drug-induced, immunologic granuloma have not been described in detail. In our experience, eosinophils are prominent in the early granulomatous reaction to medicinal compounds and under continued antigenic stimulation are accompanied by plasma cells. Eosinophils are rare to absent in tuberculous hepatic granulomas and, when present in significant numbers, militate strongly against sarcoidosis. Drug-induced granulomas are consistently noncaseous. Although Kupffer cell granulomas have many causes, they are not uncommon hypersensitivity reactions to medicinal drugs and may give rise to clinical illness. Our review suggests that the previous literature does not reflect the magnitude of drug-induced granulomatous hepatic disease and that many cases reported as "granulomatous hepatitis consistent with sarcoidosis," as well as many "undiagnosed" cases, have a drug etiology.
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PMID:Drug-induced granulomatous hepatitis. 745 31

In a southern Italy hospital, in five years 1523 liver biopsy specimens have been performed and histologically examined. Granulomas are found in specimens from 15 patient (1%). They are seven females and eight males with an average age of 57 years (range 43-71). Seven of the 15 specimens are Menghini-type percutaneous needle, five are surgical and three are laparoscopic bioptic specimens. Four patients are correlated with infectious diseases: 2 with hepatitis C virus (HCV), 1 with hepatitis B virus (HBV) and 1 with Mycobacterium Tuberculosis. In three patients the diagnosis is primary biliary cirrhosis (PBC), in two sarcoidosis, in other two pseudosarcoid reaction to abdominal tumours (a gall-bladder cancer and a non-Hodgkin lymphoma of the stomach). Finally there are 2 lipogranulomas, 1 foreign-body granuloma and 1 cholesterin granuloma. This work underlines the high prevalence in our series of PBC and sarcoidosis in the etiology of hepatic granulomas and the high frequency of patients with markers of HCV or HBV in granulomatous hepatitis.
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PMID:[Granulomatous hepatitis in a hospital population in southern Italy]. 780 98

The finding of epithelioid cell granulomas within liver biopsies is a not uncommon occurrence. We undertook this study to investigate the underlying conditions responsible for a diagnosis of granulomatous hepatitis in Northern Ireland during the thirteen year period 1980-1992. One hundred and sixty-three patients with hepatic granulomas were identified, accounting for 4% of all liver biopsies undertaken during the period of the study. In 145 cases (89%) a definite clinical diagnosis was established. The most common clinical diagnoses were primary biliary cirrhosis which accounted for 90 cases (55%) and sarcoidosis which accounted for 30 cases (18%). Other less common conditions associated with hepatic granulomas included tuberculosis (3 cases), Crohn's disease (3 cases), chronic active hepatitis (2 cases), drug hypersensitivity (2 cases) and extra-hepatic biliary obstruction (2 cases). Six patients were identified with a clinical diagnosis of psoriasis. Other miscellaneous conditions accounting for single examples of granulomatous inflammation were schistosomiasis, gout, Hodgkin's disease, secondary adenocarcinoma, collapse and necrosis of tumour following radiotherapy and chemotherapy, granulomatous inflammation within the wall of an abscess cavity and idiopathic cirrhosis. Only eighteen cases (11%) remained idiopathic with no definite diagnosis established after detailed investigation. The findings confirm the wide range of clinical conditions which can result in hepatic epithelioid cell granulomas. This has been emphasised in several previous major studies which are reviewed in this paper.
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PMID:Hepatic granulomas in Northern Ireland: a thirteen year review. 782 89

We report a young West Indian man who presented with non-specific constitutional symptoms and widespread subcutaneous nodules which were non-diagnostic on histology. The diagnosis of sarcoidosis was made on the basis of progressive bilateral hilar lymphadenopathy, interstitial pulmonary infiltration, a raised serum angiotensin-converting-enzyme level and a granulomatous hepatitis. All symptoms and signs improved dramatically on corticosteroid therapy.
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PMID:Sarcoidosis presenting as multiple subcutaneous nodules. 795 85

Elevation of the serum angiotensin-converting enzyme (sACE) level and hepatic granulomas were found during a clinical relapse in a 22 year old patient with acute viral hepatitis type A (AVH-A). The serum transaminase level and sACE level remained high for more than 6 months. In the biopsied specimen of the liver, fibrous rings of granulomas composed of collagen types I, III, and V were observed. Furthermore, the localization of ACE was visible in the rough endoplasmic reticulum of epithelioid cells of granulomas in the liver under electron microscopy using the indirect immunoperoxidase method. These results suggest that granuloma cells in the liver caused by hepatitis A may be involved in ACE production. In addition, other diseases associated with the presence of granulomas in the liver, such as lymphoma, cytomegalovirus infection, visceral leishmaniasis, and lupoid hepatitis, were ruled out. However, the hepatic granulomas disappeared with the healing of AVH-A. In this regard, the present case is considered to be one of the very few cases of hepatic sarcoidosis.
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PMID:A patient with hepatic granuloma formation and angiotensin-converting enzyme production by granuloma cells during clinical relapse of hepatitis A. 804 9

The causes of granulomatous hepatitis are often difficult to determine and standard diagnosis methods for tuberculous hepatitis lack sensitivity, which led us to evaluate the contribution of mycobacteria serology. The case is reported of a woman in whom a diagnosis of extrapulmonary sarcoidosis had been made on two occasions (1985, 1987) in the presence of granulomatous hepatitis. Liver histology remained identical in 1991 but the existence of positive mycobacteria serology led to the start of antituberculous treatment. The satisfactory response in terms of clinical, laboratory and histological findings confirmed this diagnostic hypothesis. When search for the etiology of granulomatous hepatitis proves negative, positive mycobacteria serology is sufficient to justify specific antituberculous treatment.
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PMID:[The value of mycobacteria serology in the diagnosis of tubercular hepatitis]. 806 83

Extraintestinal manifestations of Crohn's disease include a number of inflammatory diseases. The clinical activity of these associated diseases may in some cases parallel that of the intestinal inflammation. The activity of extraintestinal manifestations may however be paramount. A cause and effect relationship has not been shown for extraintestinal manifestations such as eye involvement, arthritis and accompanying hepatitis. The histological changes of extraintestinal manifestations consists of noncaseating granulomas that are difficult to distinguish from granulomas occurring in other systemic inflammatory diseases. This report is on a female patient with lower abdominal pain, fatigue, night-sweat, weight loss, episcleritis and diarrhea without blood and slime. Noncaseating granulomas were found in the colon and liver, but not in the lung. The differential diagnosis between the extrapulmonary manifestation of sarcoidosis and a generalized Crohn's disease is discussed. Hypocalcemia, large bowel involvement and missing histological changes in lung tissue rather support the diagnosis of Crohn's disease, particularly because the high CD4/CD8-quotient found in the bronchial lavage is not only characteristic for sarcoidosis but also found in Crohn's disease. Abdominal pain, diarrhea, night-sweat, weight loss and inflammation parameters like CRP and anaemia normalized under therapy with prednisone within a couple of months.
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PMID:[Differential diagnosis of granulomatous diseases--epithelioid cell granuloma in the intestine and liver in Crohn disease?]. 807 97


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