Friday 30 May 2003
Definition: Presence of hepatic granulomas in the liver.
Granulomas are uncommon in hepatitis C but can occur in patients treated with interferon. Talc granulomas can occur in intravenous drug users and can be detected by viewing under polarised light.
Other systemic granulomatous disease such as chronic metal toxicity (such as beryllium or copper) can also involve the liver.55 Finally, a study of granulomatous hepatitis cases over a 13-year period identified 11% as idiopathic.79 These cases can present with fever of unknown origin and generally respond favourably to steroids.
The granulomas can be present in the portal tracts or the parenchyma and lack necrosis.
In primary biliary cirrhosis, the granulomas are centred on the bile ducts.
- tuberculoid granuloma (epithelioid granuloma)
- macrophagic granuloma
- fibrin-ring granuloma
talc granulomas ( intravenous drug users)
systemic granulomatous disease
- chronic metal toxicity (such as beryllium or copper)
primary biliary cirrhosis (granulomas centred on the bile ducts)
carbamazepine (Tegretol) (carbamazepine-induced granulomatous hepatitis)
- systemic granulomatosis
Carbamazepine induced granulomatous hepatitis. Swinburn BA, Croxson MS, Miller MV, Crawford KB. N Z Med J. 1986 Mar 12;99(797):167. PMID: 3457299