Sarcoidosis is a multi system disease with different clinical presentations. Asymptomatic presentation is the commonest, but others include jaundice with chronic cholestasis, cirrhosis, portal hypertension, hepatic venous outflow tract obstruction and extrahepatic biliary obstruction. Cirrhosis and portal hypertension are the rarest manifestation of hepatic sarcoid and represent less than 1% of all cases. Acute on chronic liver failure as a presentation of sarcoidosis has never been reported before. Here we present a patient of sarcoidosis presenting with acute on chronic liver failure, and in whom, steroid therapy improved liver failure with a good outcome.
Key words: Sarcoidosis, ACLF, liver failure, jaundice, hepatic encephalopathy, granulomas
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