Shkolnik Lauren E, Shin Reuben D, Brabeck David M, Rothman Richard D
Department of Medicine, Lahey Clinic Medical Center, Burlington, Massachusetts, USA.
BMJ Case Rep. 2012 Jul 13;2012:bcr2012006559. doi: 10.1136/bcr-2012-006559.
Sarcoidosis is a multisystem, non-infectious, granulomatous disease of unknown cause, characterised by histological evidence of non-caseating granulomas. Gastrointestinal (GI) involvement is uncommon, reported in <1% of patients with the disease. Herein, we present a rare case of isolated gastric sarcoidosis in a patient with latent pulmonary sarcoidosis and unexplained manifestations of GI disease, illustrating that clinical disease expression is variable; may be organ-specific; and, known disease latency confined to one organ does not exclude the possibility of active disease in another organ system. In patients with organ-specific sarcoidosis, whether active or in remission, presenting with GI symptoms, the possibility of gastric sarcoidosis should be considered. Oesophagogastroduodenoscopy and biopsy, when indicated, should be considered for definitive diagnosis.
结节病是一种病因不明的多系统、非感染性肉芽肿性疾病,其特征为非干酪样肉芽肿的组织学证据。胃肠道受累并不常见,在该病患者中的报告发生率<1%。在此,我们报告一例罕见的孤立性胃结节病病例,患者有潜在的肺结节病且有不明原因的胃肠道疾病表现,这表明临床疾病表现具有多样性;可能是器官特异性的;并且,已知局限于一个器官的疾病潜伏期并不排除另一器官系统出现活动性疾病的可能性。对于有器官特异性结节病的患者,无论处于活动期还是缓解期,出现胃肠道症状时,均应考虑胃结节病的可能性。如有指征,应考虑进行食管胃十二指肠镜检查及活检以明确诊断。