Finger clubbing and cirrhosis in a sarcoidosis patient

  • Halil Yanardag Department of Internal Medicine Medicine, Cerrahpasa Medical Faculty, Istanbul Cerrahpasa University, Turkey.
  • Cuneyt Tetikkurt | tetikkurt@gmail.com Department of Pulmonary Medicine, Cerrahpasa Medical Faculty, Istanbul Cerrahpasa University, Turkey. http://orcid.org/0000-0002-4122-2908
  • Muammer Bilir Department of Internal Medicine Medicine, Cerrahpasa Medical Faculty, Istanbul Cerrahpasa University, Turkey.

Abstract

Sarcoidosis is a multisystem granulomatous inflammatory disorder frequently affecting the lungs, but also the liver, along with cirrhosis and portal hypertension occurring in less than 1% of the patients. A 56-year-old female presented with dyspnea, abdominal and leg swelling. Physical examination revealed finger clubbing, ascites and pretibial edema. Chest CT revealed diffuse micronodular opacities in both lungs without any enlarged thoracic lymph nodes. PFTs and DLCO/VA were moderately decreased. Transbronchial biopsy revealed non-caseified granulomas compatible with sarcoidosis. Serologic markers for infectious and autoimmune hepatitis were negative. Liver biopsy showed non-caseating granulomas, severe hepatitis and fibrosis. Stool, urinary analysis and antibodies for Schistosoma infection were negative. Final diagnosis was cirrhosis associated with stage III sarcoidosis. We report a case of sarcoidosis complicated by cirrhosis and portal hypertension with finger clubbing. Clinicians should bear in mind that cirrhosis, portal hypertension and clubbing may arise as the initial manifestations of sarcoidosis.

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Published
2019-10-18
Info
Issue
Section
Pneumology - Case Reports
Keywords:
Cirrhosis, liver failure, finger clubbing, sarcoidosis, portal hypertension
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  • PDF: 313
How to Cite
Yanardag, H., Tetikkurt, C., & Bilir, M. (2019). Finger clubbing and cirrhosis in a sarcoidosis patient. Monaldi Archives for Chest Disease, 89(3). https://doi.org/10.4081/monaldi.2019.1141

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