Hepatic Granulomas In Nigeria: What Aetiological Factors Do We Consider?

Abstract

Background: Granulomas are said to be present in 3% to 15% of liver biopsies with incidence figures varying by geographical location of study. In this organ, they represent an end point of a spectrum of insults, including infection, drug reaction, and other idiopathic causes. Our review of the literature does not reveal any specific report of granulomatous hepatitis from Nigeria. Objectives: To describe granulomas in the liver and the associated aetiological factors in Ibadan, Nigera Data Resources: We reviewed liver biopsy specimens received in the pathology department of the University College Hospital, Ibadan, Nigeria over a 10-year period (1983-1992). Study Selection and Data Extraction: Cases classified as granulomas were retrieved and further studied with relevant data extracted from histopathology request forms. Data Synthesis: Liver biopsy specimens represented 1.4% of all surgical biopsy specimens reported, and granulomas constituted 6.2% of liver biopsy specimens. Specific infectious causes of hepatic granuloma represent about 50% of cases in this series and tuberculosis was in the majority constituting 12.8% of hepatic granulomas, closely followed by Schistosomiasis, which represented 10.3% of cases. Idiopathic granulomas in this series represent about 26% of cases but the roles of the common usage drugs, native concoctions, and hepatitis C virus infection are unknown in this population. Conclusion: The diagnosis of granulomatous hepatitis should prompt an extensive inquisition into drug use habit. It would also seem appropriate to call for the establishment of a screening programme for hepatitis C and other newly described viruses in our country since hepatitis C and D viruses cause infections that progress commonly to chronic liver disease and cancer. Nigerian Quarterly Journal of Hospital Medicine Vol.9, No.3 (1999) pp. 193-197