Granulomatous Hepatitis

Granulomatous hepatitis refers to the presence of granulomas in the liver. It has been attributed to multiple etiologies, with sarcoidosis and primary biliary cholangitis being the most common causes in the United States, and tuberculosis worldwide. Granulomas may also be incidental findings, especially with the increased use of computed tomography (CT) and magnetic resonance imaging (MRI), but are most commonly found to be associated with an underlying systemic process. Manifestations may include right upper quadrant abdominal pain and tenderness, elevated alkaline phosphatase and transaminases, hyperbilirubinemia, jaundice, or fevers. Management is directed towards the treatment of the underlying cause.