Bocoum A-I, Daumas A, Cammilleri S, Bernard F, Rossi P, Bagneres D, Demoux A-L, Aissi K, Dales J-P, Berdah S, Chaumoitre K, Frances Y, Granel B
Service de Médecine Interne, Assistance Publique Hôpitaux de Marseille (AP-HM), Hôpital Nord, Chemin des Bourrely, 13915 Marseille cedex 15, France.
Rev Med Interne. 2011 Sep;32(9):575-9. doi: 10.1016/j.revmed.2011.03.007. Epub 2011 Apr 14.
Sarcoidosis is a systemic granulomatous disorder of unknown cause, mainly involving the lung and the mediastinum. Involvement of the pericardium and peritoneum is rare, but can be the first manifestation of the disease.
A 55-year-old female patient was followed-up for a recurrent "idiopathic" pericarditis. Diagnostis was challenged when she secondarily presented with enlarged hilar and mediastinal lymph nodes associated with pulmonary "nodules". Imaging with (18)F-FDG positron emission tomography with computed tomography showed multiple hypermetabolic foci in the mediastinum and peritoneum, which suggested a malignant disorder. Finally, histopathological evaluation of the peritoneal nodules revealed a sarcoidosis. A corticosteroid therapy was initiated and disease course was favourable.
This case report highlights the importance of a unique explanation for a patient presenting with recurrent pericarditis associated with a systemic disease. Although rare, sarcoidosis should be discussed and diagnostic procedures should be performed to obtain histological confirmation.
