Gastric Sarcoidosis: A Case Report and Review of the Literature

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. 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.

Gastric Sarcoidosis: An Atypical Presentation of a Rare Disease

“…Clinically recognizable GI involvement is uncommon occuring in less than %1 of the patients, although the incidence of subclinical disease may be much higher [1,12,13]. On the other hand, granulomas in the gastric biopsy specimens are extremely rare and are mostly associated with Crohn's disease, tuberculosis, histoplasmosis, isolated granulomatous gastritis, vasculitis, and lymphoma [7,14,15,16]. Second the symptoms were exceptional.…”

Necrotizing sarcoid granulomatosis: A case report of gastric involvement

“…4 These patients may present with nausea, vomiting, and weight loss, and are often effectively treated with a single dose of prednisone 30 to 40 mg followed by a maintenance dose of 10 to 15 mg daily over 6 months. 5 Less data are available regarding necrotizing sarcoid presentation and treatment, especially with regard to gastrointestinal involvement.…”

“…While less than 1% of sarcoid patients are reported to have gastrointestinal involvement, all of these cases have either been noncaseating granulomas (classical sarcoidosis) or were found outside the stomach. 1,4,5 Most of the data regarding sarcoid symptomatology and treatment are derived from reports on classical sarcoidosis. In classical sarcoidosis, there is gastric antral involvement in approximately 10% of patients with systemic disease.…”

Gastritis and gastropathy

“…A sarcoidosisos betegek mintegy 10%-ában jelenik meg gyomoreltérés, leggyakrabban az antrumban pylorus szűkületet, achlorhydriát okozva [31]. Az endoszkó-pia a gyomor kimeneti szakaszán hegesedést, linitis plasti cára emlékeztető rigiditást, többszörös praepyloricus fekélyt, eróziókat, a nyálkahártya polipszerű egyenetlenségeit, a redők utcakőre emlékeztető megjelenését, ritkábban atrophiát tár fel.…”