A case of severe sarcoidosis of the liver complicated with Pneumosistis carinii peumonia during long term steroid therapy

Abstract

The patient was 77-year-male who was diagnosed sarcoidosis of the skin by positive skin biopsy. Then Liver dysfunction and splenomegaly were pointed out, so he was diagnosed sarcoidosis of the liver by positive liver biopsy. After 23 months during prednisolone treatment toward sarcoidosis of the liver with portal hypertension, he complained of progressive dyspnea. He was intubated because of acute respiratory distress syndrome. His laboratory data revealed decreasing peripheral blood lymphocyte count and serum immunogloblin G, and Pneumosistis carinii-PCR was positive. These data showed that he became compromised host due to the prednisolone treatment. He was rescued by sulfamethoxazole/trimethoprim intravenous drip with methylprednisolone sodium succinate pulse therapy. We must be careful to infectious diseases according to steroid treatment for severe sarcoidosis of the liver.