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KMID : 0602620010070010095
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Korean Journal of Hepatology
2001 Volume.7 No. 1 p.95 ~ p.99
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A Case of Granulomatous Hepatitis Associated with Common Variable Immunodeficiency
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오태훈/Tae Hoon Oh
이한주/이태윤/송병철/정영화/이영상/유은실*/서동진/Han Chu Lee/Tae Yoon Lee/Byung-Cheol Song/Young-Hwa Chung/Yung Sang Lee/Eun Sil Yu*/Dong Jin Suh
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Abstract
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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.
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