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Gastric Sarcoidosis: A Case Report and Review of the Literature

Mark Friedman, MD, M Aamir Ali, MD, Marie L. Borum, MD, EdD, MPH
Volume: 100 Issue: 3 March, 2007

Abstract:

Sarcoidosis is a systemic granulomatous disease of unknown etiology that is characterized by the formation of noncaseating granulomas. Gastrointestinal (GI) tract involvement in sarcoidosis is rare. Gastric sarcoidosis, particularly involving the antrum, affects approximately 10% of patients with systemic disease.1 GI sarcoidosis commonly occurs subclinically, with clinical manifestations present in only 0.1 to 0.9% of patients with the disease.


This is a rare case report of an individual with symptomatic gastric sarcoidosis. The patient presented with weight loss, nausea, and early satiety. An EGD and colonoscopy were performed and were grossly normal. However, biopsies of the gastric antrum revealed noncaseating granulomatous inflammation involving the gastric mucosa. Corticosteroid therapy was started and the symptoms abated almost immediately. We also offer a review of the literature.


Key Points


* Symptomatic gastric sarcoidosis is a rare disease.


* The clinical manifestations of gastric sarcoidosis include abdominal pain, weight loss, nausea, vomiting, early satiety, and upper GI bleeding.


* Histological evidence of noncaseating granulomas consistent with sarcoidosis is necessary for diagnosis.


* Treatment with corticosteroid therapy usually causes resolution of symptoms.

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References:

1. Fireman Z, Sternberg A, Yarchovsky Y, et al. Multiple antral ulcers in gastric sarcoid. J Clin Gastroenterol 1997;24:97–99.
 
2. Sprague R, Harper P, McClain S, et al. Disseminated gastrointestinal sarcoidosis: case report and review of the literature. Gastroenterology 1984;87:421–425.
 
3. Farman J, Ramirez G, Rybak B, et al. Gastric sarcoidosis. Abdom Imaging 1997;22:248–252.
 
4. Akinyemi E, Rohewal U, Tangorra M, et al. Gastric sarcoidosis. J Natl Med Assoc 2006;98:948–949.
 
5. Sharma A, Kadakia J, Sharma O. Gastrointestinal sarcoidosis. Semin Respir Med 1992;6:442.
 
6. Kaneki T, Koizumi T, Yamamoto H, et al. Gastric sarcoidosis: a single polypoid appearance in the involvement. Hepatogastroenterology 2001;48:1209–1210.
 
7. Chinitz M, Brandt L, Frank M, et al. Symptomatic sarcoidosis of the stomach. Dig Dis Sci 1985;30:682–688.
 
8. Chlumsky J, Krtek V, Chlumska A. Sarcoidosis of the stomach: endoscopic diagnosis and possibilities of conservative treatment. Hepatogastroenterology 1985;32:255–257.

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