Multisystemic Sarcoidosis with Early Gastrointestinal Symptoms

Sarcoidosis involving the digestive tract is very rare and requires a strict differential diagnosis with other systemic granulomatous diseases. We present a case of multisystemic granulomatosis involving the stomach and colon, causing initial digestive symptoms. Pulmonary nodules, pleural effusion, ascites, hepatomegaly, splenomegaly, and mesenteric as well as retroperitoneal and axillary lymphadenopathy were subsequently identified. The reticulo-endothelial expression, the hypercalcemia and, above all, a rapid and complete resolution after corticosteroids supported the hypothesis of sarcoidosis involving the digestive tract. A brief review of digestive tract involvement in sarcoidosis and of the distinctive features of sarcoidosis with gastrointestinal involvement and Crohn’s disease with a rare form of pleuropulmonary involvement is presented.

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Bibliographic Details
Main Authors: Mota,Catarina, Ferreira,Carlos, Oliveira,Maria Emília, Santos,João Meneses, Victorino,Rui M.M.
Format: Digital revista
Language:English
Published: Sociedade Portuguesa de Gastrenterologia 2017
Online Access:http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452017000300007
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Description
Summary:Sarcoidosis involving the digestive tract is very rare and requires a strict differential diagnosis with other systemic granulomatous diseases. We present a case of multisystemic granulomatosis involving the stomach and colon, causing initial digestive symptoms. Pulmonary nodules, pleural effusion, ascites, hepatomegaly, splenomegaly, and mesenteric as well as retroperitoneal and axillary lymphadenopathy were subsequently identified. The reticulo-endothelial expression, the hypercalcemia and, above all, a rapid and complete resolution after corticosteroids supported the hypothesis of sarcoidosis involving the digestive tract. A brief review of digestive tract involvement in sarcoidosis and of the distinctive features of sarcoidosis with gastrointestinal involvement and Crohn’s disease with a rare form of pleuropulmonary involvement is presented.