Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for evaluation of hepatic sarcoidosis. Reports [asymptomatic / RUQ discomfort / fatigue / pruritus / weight loss]. Denies jaundice, hematemesis, or melena. Known history of systemic sarcoidosis with [pulmonary / cutaneous / ocular] involvement. Current symptoms duration: [duration]. Review of systems positive for [fever / night sweats / arthralgia].
Clinical Examination Findings
Abdominal exam: Liver [palpable / non-palpable], span [cm], [tender / non-tender] to palpation. Spleen [palpable / non-palpable]. No evidence of ascites, caput medusae, or peripheral edema. Skin: [no jaundice / scleral icterus present]. Lymphadenopathy: [cervical / axillary / inguinal] nodes [not palpable / palpable].
Treatment Protocol
Plan: 1. Monitor LFTs and alkaline phosphatase levels. 2. Initiate corticosteroid therapy: [Prednisone dose/taper schedule]. 3. Consider second-line agents (e.g., Ursodeoxycholic acid for cholestasis, or immunosuppressants like Azathioprine/Methotrexate) if refractory. 4. Monitor for complications of portal hypertension. 5. Follow-up imaging [US/CT/MRI] in [timeframe].