Diagnostic and therapeutic challenges of hepatic sarcoidosis.

The authors report three cases of hepatic sarcoidosis complicated by portal hypertension in Caucasian patients. The cases varied in their presentations from normal liver function to symptomatic cholestasis and established liver cirrhosis. In one particular case the authors discovered hepatic sarcoid after a diagnostic gastroscopy for upper gastrointestinal (GI) bleeding which showed changes of portal hypertension.

Hepatitis C and treatment with pegylated interferon and ribavirin.

Hepatitis C is a hepatotropic RNA virus with a propensity to cause chronic infection, causing a worldwide burden of chronic hepatitis, cirrhosis and hepatocellular carcinoma. Both viral elimination and hepatocellular damage are thought to be immune mediated with T-helper and cytotoxic T-lymphocytes central to these events. A delay in the onset of adaptive immunity following infection indicates that a defect in the innate immune response may lead to viral persistence with a combination of other mechanisms subsequently contributing.