title: Sarcoidosis: an extremely rare cause of granulomatous enterocolitis.
abstract: Clinically recognizable gastrointestinal (GI) system involvement with sarcoidosis is extremely rare. We present a case of a 51-year-old Caucasian male who was evaluated for abdominal pain, elevated liver enzymes, leukopenia, thrombocytopenia, severe peripheral arthralgias, and chronic watery diarrhea. He had a history of mediastinal and periaortic lymphadenopathy. Extensive laboratory work up for liver diseases, infections, malabsorption and a bone marrow biopsy was essentially unremarkable. Eso-gastroduodenoscopy was unremarkable. Colonoscopy showed scattered right colon ulcerations and erythema. The terminal ileum appeared normal. Biopsies from the duodenum, terminal ileum, and colon showed intramucosal non-caseating granulomas with focal multinucleate giant cell formation in a background of chronic active duodenitis, ileitis, and colitis. Liver biopsy showed moderate non-specific chronic hepatitis with non-caseating granulomas present within portal and lobular parenchyma. The clinical presentations, along with biopsy results were suggestive of sarcoidosis. The patient was started on prednisone and had a significant improvement in his symptoms including diarrhea.
authors.affiliation: Department of Internal, University of Missouri, Columbia, MO 65212, USA. mohsmadi@hotmail.com
authors.forename: Mohammad
authors.initials: M
authors.lastname: Esmadi
authors.forename: Dina S
authors.initials: DS
authors.lastname: Ahmad
authors.forename: Brian
authors.initials: B
authors.lastname: Odum
authors.forename: Alberto
authors.initials: A
authors.lastname: Diaz-Arias
authors.forename: Hazem
authors.initials: H
authors.lastname: Hammad
mesh_terms: D001706:Biopsy; D004382:Duodenitis / Q000175:diagnosis; D004386:Duodenum / Q000473:pathology; D004760:Enterocolitis / Q000175:diagnosis*; D006099:Granuloma / Q000175:diagnosis*; D006521:Hepatitis, Chronic / Q000175:diagnosis; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012507:Sarcoidosis / Q000175:diagnosis*