Hepatic granulomas: etiologic distribution.

It has been reported that HGs are found in approximately 5% (1.6%-15%) of patients who undergo a liver biopsy and may be caused by a variety of conditions (2). Differences in the rate of HGs and the underlying systemic disorders depend on the location of the study and the patient population. HGs may result from a primary liver disease or an ongoing systemic disease. Various causes of HG may be subdivided into infections (particularly brucellosis, miliary TB, pulmonary TB, Q-fever), sarcoidosis, primary biliary cirrhosis (PBC), and drugs. The cause of HG may remain unclear, despite careful evaluation, in approximately 20% of patients (idiopathic HG). Liver biopsies of patients with chronic hepatitis C and B virus infections may show HG in ~1% of cases (3-5). Typhoid fever may also rarely cause HG (6).