Granulomatous Hepatitis

Abstract

Granulomatous hepatitis is etiologically related to many diseases. Diagnosis is difficult in patients whose liver biopsys demonstrate noncaseating granulomata in the absence of identifiable organisms. Three to 10% of liver biopsies performed at general hospitals demonstrate granulomata. Sixty-three patients with granulomatous hepatitis were studied between Jan. 1947, and March 1966, 53% had tuberculosis, 12% sarcoidosis, and in 20% an etiologlcal diagnosis could not be made. Three patients had disseminated fungal infections, 1 brucellosis, 1 leprosy, 1 Wegener''s granulomatosis, and 3 had Hodgkin''s disease. An increased frequency of granulomata in liver biopsies during the last 6 yr. of this study was demonstrated, probably as a result of increased number of liver biopsies performed during that period. Also, as the number of liver biopsies done yearly increased, the number of patients with granulomata of the liver due to unknown etiology increased. The symptoms, physical findings, laboratory data, and liver histopathology are discussed, and differences between the etiological granulomatous diseases are emphasized. A discussion of the various diseases associated with granulomatous hepatitis is presented.