A case of idiopathic granulomatous hepatitis in an HIV-infected patient / 대한내과학회지

ABSTRACT

Patients infected with human immunodeficiency virus (HIV) may develop various liver diseases, including viral hepatitis, granulomatous inflammation, malignancies, vascular disease, drug-induced hepatitis and, sometimes, diseases of unknown origin. In this case, a 35-year-old HIV-infected man presented with fatigue, myalgia, elevated liver enzymes, and multiple skin lesions for 3 months. Since the abdominal computed tomography (CT) and viral marker tests failed to explain the cause of his symptoms and signs, a liver biopsy was performed. This revealed a granuloma consisting of epithelioid cells without necrosis. His symptoms, skin lesions, and abnormal liver enzymes improved without changing his management, including the anti-retroviral agents. He was diagnosed with idiopathic granulomatous hepatitis based on the pathologic findings of the liver and clinical course. Aggressive diagnostic methods, such as a liver biopsy, should be considered for HIV-infected patients with liver disease.