Abstract

RONDON-CARVAJAL, Julián; REYNA-CARRASCO, Óscar  and  LARA-VIAFARA, Melissa. Granulomatous hepatitis, deciphering an elusive spectrum: a clinical case-based approach. Rev. colomb. Gastroenterol. [online]. 2023, vol.38, n.3, pp.383-391.  Epub Jan 19, 2024. ISSN 0120-9957.  https://doi.org/10.22516/25007440.980.

Granulomatous hepatitis is a well-defined histopathologic entity characterized by aggregates of modified macrophages (epithelioid in appearance) and other inflammatory cells that accumulate after persistent exposure to antigens. It induces a cellular immune response mediated by the release of various cytokines (including interferon-gamma [INF-γ], tumor necrosis factor-alpha [TNF-α], and interleukin 12 [IL-12]) that stimulate mononuclear cell fusion, culminating in the formation of multinucleated giant cells with a surrounding border of lymphocytes and fibroblasts. It represents between 2% and 15% of all pathological liver studies, usually during an infiltrative or cholestatic biochemical pattern. A practical approach is proposed based on a challenging clinical case of a patient with a fever of unknown origin in an intermediate incidence area for tuberculosis, such as Colombia.

Keywords : Granuloma; hepatitis; sarcoidosis; tuberculosis; fever of unknown origin.

        · abstract in Spanish     · text in English | Spanish     · English ( pdf ) | Spanish ( pdf )