부산대학교 도서관

An 8-year-old boy was admitted to our hospital because of anorexia, jaundice, and liver dysfunction. Based on liver biopsy, the patient was initially diagnosed with noninfectious acute hepatitis. Treatment with prednisolone (PSL) improved hepatobiliary enzyme levels. The patient was readmitted due to liver dysfunction, which recurred following PSL dose tapering. Although the re-administration of PSL was partly effective, cyclosporine and azathioprine had to be added because the liver function data did not improve sufficiently. Finally, liver biopsy revealed noncaseous epithelioid granulomas in the portal tracts. On the histopathological findings, serum angiotensin-converting enzyme and soluble interleukin-2 receptor levels were elevated; thus, the patient was diagnosed with hepatic sarcoidosis. Combined steroid pulse therapy and azathioprine markedly improved liver function data and histological findings. Case reports of hepatic sarcoidosis in children are rare, but this disease should not be overlooked as a possible cause of acute liver dysfunction based on immunological abnormalities.