Introduction. Primary biliary cirrhosis (PBC) is an immunemediated chronic
progressive inflammatory liver disease leading to destruction of small
interlobular bile ducts. Sarcoidosis is a chronic disorder of unknown
etiology characterized by non-caseous granulomas. Case report. We reported a
69-year-old female patient with abdominal pain, malaise, vertigo, headaches,
hands tremor and partial loss of hearing. Initial laboratory findings
revealed elevated liver function tests and cholesterol with positive
antimytochondrial and antinuclear antibodies. Liver biopsy revealed granuloma
typical for PBC and granulomatous lesions typical for sarcoidosis. Elevated
serum angiotensin-converting enzyme and granulomatous lesion on the brain
magnetic resonance imaging (MRI) were detected and the patient was diagnosed
with overlap of PBC and liver sarcoidosis and neurosarcoidosis. The patient
was treated with ursodeoxicholic acid (UDCA) and prednisolone. Six months
later the patient was symptom-free with laboratory findings within normal
range. Conclusion. In PBC patients it is important to consider coexisting
granulomatous liver diseases if elevated liver function tests persist despite
UDCA therapy.
Gilbert Syndrome in a Young Ethiopian Man: First Case Report