Brief Answer: You should undergo further examinations, guided by a gastroenterologist and an infections diseases doctor. Detailed Answer: Hello, Thank you for using HCM. Granulomas, rarely cause structural liver damage, even though they may be the first clue to an ongoing systemic disease, which is important to be detected and treated. Even though the causes of hepatic granulomatous disease are numerous, the most common causes include sarcoidosis, primary biliary cirrhosis, and tuberculosis. A comprehensive medical history and physical examination should be pursued along with an extensive medication and travel history. Being based on this, the specialist will advice you to do further examinations such as a chest radiography, cultures for bacteria, mycobacteria, viruses, and fungi. Serologies for hepatitis B, C, as well as syphilis, Q fever, and brucella etc. can also be pursued. Lupus, is not a known cause of hepatic granulomas. Eventually, for a definitive etiologic diagnosis can only be useful a histologic examination of liver biopsy. Hope this is helpful. Let me know if you need more clarifications. Otherwise please close and rate the answer. Kind Regards, Dr. Juarda