title: Liver sarcoidosis that presented with dysphagia.
abstract: We report a case of liver sarcoidosis with dysphagia. Although akinesia of the soft palate, disappearance of the palatal reflex, and pyramidal signs indicated brainstem lesions, brain magnetic resonance imaging showed no lesion and the focus was obscure. Iritis, parotiditis, and hilar lymphadenopathy supported the diagnosis of sarcoidosis. However, lung biopsy was normal. Finally, sarcoidosis was diagnosed by liver biopsy. We speculated that microgranulomas in the brainstem that did not exhibit imaging abnormalities causing the neurological symptoms and that liver biopsy can be an effective diagnostic tool even for cases that presented with neurological signs, but no gastrointestinal symptom.
authors.affiliation: Department of Internal Medicine, Toyama City Hospital, Toyama, Japan. kimiharu@beige.plala.or.jp
authors.forename: Miharu
authors.initials: M
authors.lastname: Samuraki
authors.forename: Takuya
authors.initials: T
authors.lastname: Nakahashi
authors.forename: Shou
authors.initials: S
authors.lastname: Aoyama
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Hinoue
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Takahashi
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Saito
authors.forename: Shigeru
authors.initials: S
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D003680:Deglutition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D010292:Paresthesia / Q000209:etiology; D012507:Sarcoidosis / Q000150:complications / Q000175:diagnosis* / Q000473:pathology