title: Digestive-tract sarcoidosis: French nationwide case-control study of 25 cases.
abstract: Digestive tract sarcoidosis (DTS) is rare and case-series are lacking. In this retrospective case-control study, we aimed to compare the characteristics, outcome, and treatment of patients with DTS, nondigestive tract sarcoidosis (NDTS), and Crohn disease.We included cases of confirmed sarcoidosis, symptomatic digestive tract involvement, and noncaseating granuloma in any digestive tract. Each case was compared with 2 controls with sarcoidoisis without digestive tract involvement and 4 with Crohn disease.We compared 25 cases of DTS to 50 controls with NDTS and 100 controls with Crohn disease. The major digestive clinical features were abdominal pain (56%), weight loss (52%), nausea/vomiting (48%), diarrhea (32%), and digestive bleeding (28%). On endoscopy of DTS, macroscopic lesions were observed in the esophagus (9%), stomach (78%), duodenum (9%), colon, (25%) and rectum (19%). As compared with NDTS, DTS was associated with weight loss (odds ratio [OR] 5.8; 95% confidence interval [CI] 1.44-23.3) and the absence of thoracic adenopathy (OR 5.0; 95% CI 1.03-25). As compared with Crohn disease, DTS was associated with Afro-Caribbean origin (OR 27; 95% CI 3.6-204) and the absence of ileum or colon macroscopic lesions (OR 62.5; 95% CI 10.3-500). On the last follow-up, patients with DTS showed no need for surgery (versus 31% for patients with Crohn disease; P = 0.0013), and clinical digestive remission was frequent (76% vs. 35% for patients with Crohn disease; P = 0.0002).The differential diagnosis with Crohn disease could be an issue with DTS. Nevertheless, the 2 diseases often have different clinical presentation and outcome.
authors.affiliation: AP-HP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne and Inflammation-Immunopathology-Biotherapy Department (DHU i2B) APHP, Hôpital Pitié-Salpétrière, Sorbonne Universités, UPMC Université Paris 06, service de médecine interne APHP, Hôpital Tenon, Sorbonne Universités, UPMC Université Paris 06, Public health department APHP, Hôpital Saint-Antoine, Sorbonne Universités, UPMC Université Paris 06, service de gastro-entérologie, Paris Hôpital de la Croix-Rousse, Hospices Civils de Lyon, department of internal medicine, F-Lyon. University Claude Bernard Lyon 1, F-69100, Villeurbanne. Hôpital Claude Huriez, service de médecine interne, Lille, France APHP, Hôpital Avicenne, service de médecine interne, université Paris 13, Bobigny, France Department of internal medicine, Division of internal medicine and rehabilitation, rehabilitation and geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland APHP, Hôpital Avicenne, Université Paris 13, service de pneumologie, Bobigny Hôpital Evreux, service de pneumologie, Evreux APHP, Hôpital Avicenne, Université Paris 13, service de médecine nucléaire APHP, Hôpital Avicenne, Université Paris 13, service de gastro-entérologie, Bobigny, France .
authors.forename: Etienne
authors.initials: E
authors.lastname: Ghrenassia
authors.forename: Arsene
authors.initials: A
authors.lastname: Mekinian
authors.forename: Catherine
authors.initials: C
authors.lastname: Chapelon-Albric
authors.forename: Pierre
authors.initials: P
authors.lastname: Levy
authors.forename: Jacques
authors.initials: J
authors.lastname: Cosnes
authors.forename: Pascal
authors.initials: P
authors.lastname: Sève
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lefèvre
authors.forename: Robin
authors.initials: R
authors.lastname: Dhôte
authors.forename: David
authors.initials: D
authors.lastname: Launay
authors.forename: Virginie
authors.initials: V
authors.lastname: Prendki
authors.forename: Sandrine
authors.initials: S
authors.lastname: Morell-Dubois
authors.forename: Danielle
authors.initials: D
authors.lastname: Sadoun
authors.forename: Anas
authors.initials: A
authors.lastname: Mehdaoui
authors.forename: Michael
authors.initials: M
authors.lastname: Soussan
authors.forename: Anne
authors.initials: A
authors.lastname: Bourrier
authors.forename: Laure
authors.initials: L
authors.lastname: Ricard
authors.forename: Robert
authors.initials: R
authors.lastname: Benamouzig
authors.forename: Dominique
authors.initials: D
authors.lastname: Valeyre
authors.forename: Olivier
authors.initials: O
authors.lastname: Fain
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003424:Crohn Disease / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004066:Digestive System Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D016145:Endoscopy, Digestive System; D005260:Female; D005602:France; D006801:Humans; D008297:Male; D008875:Middle Aged; D012075:Remission, Spontaneous; D012507:Sarcoidosis / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D055815:Young Adult