01589nas a2200205   4500000000100000008004100001653002400042653001200066653002800078653001700106100001900123700001500142700001700157700001700174245008600191856005100277300001200328490000700340520103600347       2018                            d10aHansen’s diseases10aleprosy10aGranulomatous hepatitis10aLiver biopsy1 aBraghiroli NFA1 aOliveira P1 aSadigursky M1 aMachado AR L00aDiagnosing lepromatous leprosy by liver biopsy: A case of granulomatous hepatitis  uhttps://leprosyreview.org/article/89/3/30-6309  a306-3090 v893 a<p>Hansen’s disease (HD) is a chronic and contagious disease caused by Mycobacterium leprae. After the neurocutaneous system and the lymph nodes, the liver is the organ most commonly affected, secondary to hematogenous dissemination of the bacilli to the liver, immune-mediated inflammatory infiltrate in reactional states or due amyloid deposits may also be detected in the liver. The authors report on a patient with lepromatous HD whose initial symptoms and diagnosis relied in the presence of granulomatous hepatitis by liver biopsy. Although liver involvement in leprosy is more frequent than suspected, clinical manifestations resulting from its damage are uncommon. Therefore, when treating a patient with multibacillary HD, physicians should be aware that this is a multisystemic disease and that multiple organs may be affected. Furthermore this case also shows that the slow skin infiltration in lepromatous HD may be associated with lack of clinical diagnosis and favor a severe compromise in internal organs.</p>