<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2341-4545</journal-id>
<journal-title><![CDATA[GE-Portuguese Journal of Gastroenterology]]></journal-title>
<abbrev-journal-title><![CDATA[GE Port J Gastroenterol]]></abbrev-journal-title>
<issn>2341-4545</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Gastrenterologia]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2341-45452025000100061</article-id>
<article-id pub-id-type="doi">10.1159/000539226</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Navigating Challenges in a Case of Unusual Hepatic and Pulmonar Sarcoidosis: A Comprehensive Clinical Journey]]></article-title>
<article-title xml:lang="pt"><![CDATA[Resolução de desa&#64257;os num caso atípico de sarcoidose hepática e pulmonar]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gonçalves]]></surname>
<given-names><![CDATA[André]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Simas]]></surname>
<given-names><![CDATA[Diogo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gomes]]></surname>
<given-names><![CDATA[Plácido]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Leal]]></surname>
<given-names><![CDATA[Carinal]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Atalaia-Martins]]></surname>
<given-names><![CDATA[Catarina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vasconcelos]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar de Leiria Department of Gastroenterology ]]></institution>
<addr-line><![CDATA[Leiria ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>02</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>02</month>
<year>2025</year>
</pub-date>
<volume>32</volume>
<numero>1</numero>
<fpage>61</fpage>
<lpage>66</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S2341-45452025000100061&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S2341-45452025000100061&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S2341-45452025000100061&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction:  Sarcoidosis, a systemic granulomatous disorder with uncertain etiology, commonly involves the lungs and, to a lesser extent, the liver.  Case Presentation:  A previously healthy 35-year-old Congolese female was admitted with a 7-month history of jaundice, itching, and weight loss. Despite markedly mixed hepatitis of a cholestatic pattern of liver injury, liver function tests remained normal in admission laboratory work. Enlarged ethiological study was negative for infections, autoimmunity, heavy metal poisoning, and metabolic diseases. Imaging aligned with compatible biopsy histology led to the diagnosis of hepatic and pulmonary sarcoidosis with vanishing bile duct syndrome. Despite initial treatment with ursodeoxycholic acid and corticosteroid therapy, the patient exhibited an unexpected exacerbation of liver enzymes, prompting a careful consideration of second-line interventions. Following discussion with a tertiary center and a comprehensive review of the literature, it was deter-mined not to intensify therapy due to an inadequate response. Recognizing the persistent challenge of managing advanced cases and the potential progressive course of the disease, the patient was referred to a tertiary transplant center. Currently, she is under outpatient follow-up, clinical and analytically stable with no targeted therapy.  Conclusion:  This case report details a rare presentation of hepatic sar-coidosis with an unusual laboratory pattern, emphasizing diagnostic and management challenges in recognizing atypical presentations of hepatic sarcoidosis. The complexity of managing advanced cases warrants a multidisciplinary approach and the limited literature on this subject empha-sizes the urgency for a more comprehensive understanding of sarcoidosis to improve diagnostic accuracy and re&#64257;ne therapeutic approaches.]]></p></abstract>
<abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo  Introdução:  A sarcoidose é uma doença granulomatosa sistémica, de etiologia não totalmente esclarecida, que afeta frequentemente os pulmões e, menos comumente, o fígado.  Caso clínico:  Mulher de 35 anos, Congolesa, previamente saudável, admitida por história de icterícia e prurido com 7 meses de evolução. Analiticamente com hepatite de padrão colestático, sem alteração das provas de função hepática. Estudo etiológico alargado negativo para infeções, doenças de autoimunidade, intoxicação por metais pesados e doenças metabólicas. Os achados imagiológicos, em conjunto com histologia de biópsia hepática, o diagnóstico de sarcoidose hepática e pulmonar associada a vanishing bile duct syndrome foi assumido. Realizado trial inicial de corticoterapia em associação com ácido ursodesoxicólico, com agravamento das enzimas hepáticas. Após revisão da literatura e discussão com centro hospitalar terciário, optou-se por não escalar terapêutica. Reconhecendo provável otimização terapêutica difícil e curso progressivo da doença, a doente foi encaminhada para um centro terciário de transplantação hepática. Atualmente, a doente mantém seguimento em consulta, sem terapêutica dirigida, estável do ponto de vista clínico e analítico.  Conclusão:  Os autores apresentam um caso raro de sarcoidose hepática com um padrão laboratorial incomum, enfatizando os desa&#64257;os diagnósticos e terapêuticos nas apresentações atípicas desta doença. A complexidade destes quadros clínicos avançados requer uma abordagem clínica multidisciplinar. A paucidade de literatura atual enfatiza a necessidade de uma melhor compreensão da sarcoidose, para aprimorar o diagnóstico e a abordagem terapêutica nestes doentes.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Gastrointestinal sarcoidosis]]></kwd>
<kwd lng="en"><![CDATA[Liver granuloma]]></kwd>
<kwd lng="en"><![CDATA[Hepatic sarcoidosis]]></kwd>
<kwd lng="en"><![CDATA[Pulmonar sarcoidosis]]></kwd>
<kwd lng="pt"><![CDATA[Sarcoidose gastrointestinal]]></kwd>
<kwd lng="pt"><![CDATA[Granuloma hepático]]></kwd>
<kwd lng="pt"><![CDATA[Sarcoidose hepática]]></kwd>
<kwd lng="pt"><![CDATA[Sarcoidose pulmonar]]></kwd>
</kwd-group>
</article-meta>
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