title: Gastrointestinal sarcoidosis associated with pneumatosis cystoides intestinalis.
abstract: A 39-year-old male reported fevers, weight loss, watery loose stools, and decreased visual acuity in his right eye over the prior five years. He was pancytopenic, had an elevated American council on exercise level, total bilirubin, and alkaline phosphatase. Computed tomography revealed massive hepatosplenomegaly and emphysematous lung changes. Liver biopsy showed non caseating granulomas. The patient was diagnosed with extrapulmonary sarcoidosis and was treated with prednisone. The patient symptomatically improved but 5 mo later presented with abdominal pain caused by perforation of the cecum. He underwent a cecectomy and pathology revealed pneumatosis cystoides intestinalis. This represents the first reported association between pneumatosis cystoides intestinalis and sarcoidosis. The etiology of pneumatosis cystoides intestinalis in this case was likely multifactorial and involved both effects of the corticosteroids as well as the advanced nature of the gastrointestinal sarcoidosis. Furthermore this case has the unique features of emphysematous lung changes and pancytopenia which are uncommon with sarcoidosis.
authors: Department of Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ 08820, United States.
authors: Hussein
authors: H
authors: Rahim
authors: Mubashir
authors: M
authors: Khan
authors: Jay
authors: J
authors: Hudgins
authors: Kevin
authors: K
authors: Lee
authors: Lei
authors: L
authors: Du
authors: Louis
authors: L
authors: Amorosa
mesh_terms: D000328:Adult; D001706:Biopsy; D005938:Glucocorticoids / Q000009:adverse effects; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D011006:Pneumatosis Cystoides Intestinalis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D011241:Prednisone / Q000009:adverse effects; D012307:Risk Factors; D012507:Sarcoidosis / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D011241:Prednisone
keywords: Corticosteroids; Emphysema; Pancytopenia; Pneumatosis cystoides intestinalis; Sarcoidosis