Granulomatous hepatitis with Crohn's disease: a case report

被引：0

作者：

Suzuki, Tatsuya ^{[1
]}

Hayakawa, Yuka ^{[1
]}

Kaneko, Shun ^{[1
]}

Takenaka, Kento ^{[1
]}

Watakabe, Keiya ^{[1
]}

Kinowaki, Yuko ^{[3
]}

Takemoto, Akira ^{[4
]}

Ohtsuka, Kazuo ^{[2
]}

Asahina, Yasuhiro ^{[1
,5
]}

Okamoto, Ryuichi ^{[1
]}

机构：

[1] Tokyo Med & Dent Univ, Dept Gastroenterol & Hepatol, 1-5-45,Yushima,Bunkyo Ku, Tokyo 1138519, Japan

[2] Tokyo Med & Dent Univ Hosp, Endoscop Unit, Tokyo, Japan

[3] Tokyo Med & Dent Univ, Grad Sch Med, Dept Comprehens Pathol, Tokyo 1138510, Japan

[4] Tokyo Med & Dent Univ, Bioresource Res Ctr, Tokyo, Japan

[5] Tokyo Med & Dent Univ, Dept Liver Dis Control, Tokyo, Japan

来源：

CLINICAL JOURNAL OF GASTROENTEROLOGY | 2024年 / 17卷 / 03期

关键词：

Granulomatous hepatitis; Crohn's disease; Portal hypertension; Extra-intestinal manifestations; PORTAL-HYPERTENSION; MANIFESTATIONS; SARCOIDOSIS;

D O I：

10.1007/s12328-024-01937-8

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

A 45-year-old man who was regularly followed up for Crohn's disease (CD) and maintained clinical remission with vedolizumab (VDZ). At 37 years old, he was diagnosed CD from longitudinal ulcers in the distal ileum by balloon-assisted enteroscopy (BAE). During the follow-up, liver enzyme elevation, splenomegaly and thrombocytopenia were in progress. Esophagogastric varices suggested chronic liver disease and portal hypertension. Magnetic resonance elastography (MRE) showed liver stiffness of 3.4 kPa and proton density fat fraction (PDFF) of 1.86%. He was diagnosed with granulomatous hepatitis based on a liver biopsy. The hepatic venous pressure gradient (HVPG) was mildly elevated at 7 mmHg, consistent with the pre-sinusoidal portal hypertension due to granulomatous hepatitis. We report a rare case with granulomatous hepatitis diagnosed from liver injury and portal hypertension, despite the stable intestinal symptoms of CD.

引用

页码：551 / 556

页数：6

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