Clinical journal of gastroenterology · 2024
Granulomatous hepatitis with Crohn's disease: a case report.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Suzuki Tatsuya, Hayakawa Yuka, Kaneko Shun, Takenaka Kento, Watakabe Keiya, Kinowaki Yuko, Takemoto Akira, Ohtsuka Kazuo, Asahina Yasuhiro, Okamoto Ryuichi
Аннотация
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.