摘要
Hepatic sarcoidosis is usually asymptomatic but rarely leads to adverse liver-related outcome.Co-existence of viral hepatitis and hepatic sarcoidosis is a rare,but recognised phenomenon.Obtaining a balance between immune suppression and anti-viral therapy may be problematic.Immunosuppression in the presence of viral hepatitis can lead to rapid deterioration of liver disease.Similarly,anti-viral therapy may exacerbate granulomatous hepatitis.Here we present two cases of viral hepatitis co-existing with sarcoidosis that illustrate successful management strategies.In one,hepatitis B replication was suppressed with oral antiviral therapy before commencing prednisolone.In the second,remission of hepatic sarcoidosis was achieved with prednisolone,before treating hepatitis C and obtaining a sustained virological response with pegylated interferon and ribavirin therapy.
Hepatic sarcoidosis is usually asymptomatic but rarely leads to adverse liver-related outcome. Co-existence of viral hepatitis and hepatic sarcoidosis is a rare, but recognised phenomenon. Obtaining a balance between immune suppression and anti-viral therapy may be problematic. Immunosuppression in the presence of viral hepatitis can lead to rapid deterioration of liver disease. Similarly, anti-viral therapy may exacerbate granulomatous hepatitis. Here we present two cases of viral hepatitis co-existing with sarcoidosis that illustrate successful management strategies. In one, hepatitis B replication was suppressed with oral anti-viral therapy before commencing prednisolone. In the second, remission of hepatic sarcoidosis was achieved with prednisolone, before treating hepatitis C and obtaining a sustained virological response with pegylated interferon and ribavirin therapy.
