Korean J Hepatol.  2001 Mar;7(1):95-99.

A Case of Granulomatous Hepatitis Associated with Common Variable Immunodeficiency

• Oh TH
• Lee HC
• Lee TY
• Song BC
• Chung YH
• Lee YS
• Yu ES
• Suh DJ

Abstract

A granuloma is a compact, organized collection of chronic inflammatory cells, predominantly consisting of mature mononuclear phagocytes. Clinical manifestations of hepatic granulomas vary widely from asymptomatic elevation of serum alkaline phosphatase activity to liver cirrhosis. The hepatic granuloma is nonspecific and represents a pathologic reaction induced by any of a number of factors. Although the causes of hepatic granuloma vary considerably according to geographic site, sarcoidosis and tuberculosis are the two leading causes. Here we present a 20-year-old female with a long history of recurrent otitis media, upper respiratory infection, and unexplained hepatosplenomegaly. A diagnosis of common variable immunodeficiency was made, based on the decreased levels of serum immunoglobulins. A liver biopsy revealed chronic granulomatous inflammation, but neither caseous necrosis nor acid-fast bacillus was found. Her liver disease progressed despite a nine-month course of antituberculous medication. Hypogammaglobulinemia should be included in the differential diagnosis of granulomatous liver disease.

Keyword

Common variable immunodeficiency; Hepatitis/Granulomatous hepatitis

MeSH Terms

Agammaglobulinemia
Alkaline Phosphatase
Bacillus
Biopsy
Common Variable Immunodeficiency*
Diagnosis
Diagnosis, Differential
Female
Granuloma
Hepatitis*
Humans
Immunoglobulins
Inflammation
Liver
Liver Cirrhosis
Liver Diseases
Necrosis
Otitis Media
Phagocytes
Sarcoidosis
Tuberculosis
Young Adult
Alkaline Phosphatase
Immunoglobulins