Granulomatous liver disease in a referral center in Mexico city.

Background: Up to 15 % of liver biopsies may reveal granulomas. The underlying causes vary geographically, with marked differences between high- and low-middle-income countries. No studies have examined the etiology of granulomatous liver disease (GLD) in Mexico.

Aims: To describe the etiologic profile and clinical outcomes of patients diagnosed with GLD at a tertiary care center in Mexico.

Methods: Retrospective cohort study of patients diagnosed with GLD by liver biopsy between 2001 and 2017.

Results: We identified 133 patients with GLD. The most common causes were infectious diseases (36.1 %, n = 48; including 22 mycobacterial infections), foreign body reactions (21.1 %, n = 28), and autoimmune disorders (15.0 %, n = 20). The overall 6-month survival probability was 90.9 % (95 % confidence interval [CI], 86-95 %), declining to 87.5 % (95 % CI, 82-93 %) at 12 months. Patients with autoimmune etiologies had the best prognosis (100 % survival at 6 and 12 months). In contrast, patients with neoplastic GLD had the poorest outcomes, with survival probabilities of 72.7 % (95 % CI, 50.6-100 %) at 6 months and 63.6 % (95 % CI, 40.7-99.5 %) at 12 months. Patients with idiopathic GLD had a favorable short-term prognosis, with a 12-month survival probability of 92 %.

Conclusions: In this cohort, infectious diseases were the most common cause of GLD. Prognosis varied by etiology, with idiopathic cases showing favorable short-term outcomes and neoplastic cases exhibiting poor survival rates.