B42-21 Hepatic Sarcoidosis: A Large Tertiary Center Experience

Abstract Introduction/Rationale Hepatic sarcoidosis (HS) is a rare manifestation of sarcoidosis occurring in 6 to 11% of patients with sarcoidosis. Little is known about the clinical characteristics and overall outcome of patients who present with HS. Two recent single center studies from Europe and the U.S. outlined the clinical characteristics, outcomes, and therapeutic interventions in these patients. Our study aims to add to this body of knowledge; in particular, highlighting the clinical presentation, therapeutic interventions, comorbid disease burden, and overall outcomes in patients with HS presenting to a large tertiary care sarcoidosis center of excellence in the U.S. Methods We performed a retrospective review of all patients with hepatic sarcoidosis (HS) seen at the Sarcoidosis Center of Excellence at East Carolina University (ECU) between 2000 and 2025. Data including demographics, clinical manifestations, diagnostic tests, treatments and outcomes, were extracted. Results A total of 794 patients with sarcoidosis were identified. Twenty-one (21) patients had over 50% of missing data and were excluded. Of the 773 patients included in the study, 62 patients (8%) had hepatic sarcoidosis. Of these, 73% were female and 79% were African American. The mean age at diagnosis was 40 years. Thirty-nine percent (39%) of patients underwent a liver biopsy and majority (64%) had a Scadding CXR I or II at diagnosis. There was no significant difference in the age (at diagnosis), race, gender, BMI, smoking status, or pulmonary function when patients with HS were compared to the rest of the cohort (n = 711) (Table 1). CXR Scadding stage at presentation was also similar except that 5% of non-HS patients had a stage IV CXR at presentation compared to 0 patients with HS (Table 1). Evaluation for other organ involvement revealed that patients with HS were more likely to have splenic, Calcium-Vit D dysregulation, extra-thoracic lymphadenopathy, and bone/bone marrow involvement than non-HS patients (Table 2/Figure 1). Treatment patterns including use of methotrexate and infliximab were identical except that only 5% of patients were treated with ursodiol. This was unexpectedly low (Table 3). Outcomes including fatigue at any point during the follow-up and mortality are presented in Table 4. 10.4% of non-HS patients died versus 4.9% of HS patients. No patients in our cohort underwent a liver transplant. Conclusion Hepatic sarcoidosis was found in 8% of patients and was associated with multi-organ disease. Patients received similar medications, including methotrexate, as patients without hepatic sarcoidosis. This abstract is funded by: None