Granulomas in Pediatric Liver Biopsies: Single Center Experience.
Pediatr Dev Pathol
; 27(3): 218-227, 2024.
Article
in En
| MEDLINE
| ID: mdl-38221675
ABSTRACT
BACKGROUND:
Granulomas in pediatric liver biopsies (GPLB) are rare with the largest pediatric cohort reported over 25 years ago.METHODS:
Single-center retrospective study of GPLB.RESULTS:
Seventeen liver biopsies from 16 patients with granulomas were identified (9 boys, 56%) with a median age of 13 years (range 1-18) for which the most common indication was the presence of a nodule/mass (47%). Significant comorbidities were seen in 13 patients (81%) and included liver transplant (25%), history of a neoplasm (25%), autoimmune hepatitis (6%), Crohn disease (6%), bipolar disorder (6%), severe combined immunodeficiency (6%), and sickle cell disease (6%). Eleven patients were taking multiple medications at the time of biopsy. Granulomas were more commonly pan-acinar (11 cases) followed by subcapsular (4 cases), portal (1 case), and periportal (1 case). Necrosis was seen in 10 cases (59%). GMS stain was positive in 2 cases for Histoplasma-like yeast; microbiological cultures were negative in all cases (no 4). A 18S and 16S rRNA gene sequencing performed in 15 cases revealed only 1 with a pathogenic microorganism, Mycobacterium angelicum.CONCLUSION:
In our experience, GPLB are heterogenous with only 3 cases having an identifiable infectious etiology and many of the remaining cases being associated to multiple medications, suggesting drug-induced liver injury as possible etiology.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Granuloma
/
Liver Diseases
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Language:
En
Journal:
Pediatr Dev Pathol
Journal subject:
PATOLOGIA
/
PEDIATRIA
Year:
2024
Document type:
Article
Affiliation country:
United States
Country of publication:
United States