EDITOR'S QUIZ: GI SNAPSHOT
EDITOR’S QUIZ: GI SNAPSHOT
Keywords: Sarcoidosis; obstructive jaundice
| The first 150 words of the full text of this article appear below. |
From question on page 1346
The CT scan shows intra-hepatic and extra-hepatic ductal dilatation with extensive extrahepatic lymphadenopathy. The histology of the lymph-node biopsy shows non-caseating histiocytic granulomata with giant cells and asteroid bodies. The histology shows that stains for acid-fast bacilli and fungi were negative.
Serum angiotensinogen-converting enzyme was raised, at 61 U/l (normal range 25–82). A diagnosis of sarcoidosis causing obstructive jaundice was made, and the patient was started on corticosteroids. Liver-function tests returned to within normal limits and the patient’s symptoms completely resolved.
A repeat CT scan of the abdomen, 11 months after the initial consultation, showed complete resolution of intrahepatic bile duct dilatation and a marked improvement in lymphadenopathy.
Sarcoidosis is a systemic inflammatory disease characterised by the formation of non-caseating granulomas. The aetiology remains unknown, but speculation has focused on an unidentified environmental factor triggering a response in susceptible individuals. The prevalence is highest in
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Gut 2007 56: 1346.[Extract] [Full Text] [PDF]
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