Mota Catarina, Ferreira Carlos, Oliveira Maria Emília, Santos João Meneses, Victorino Rui M M
Medicine II Department, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal.
Pathology Department, Hospital de Santa Maria, Centro Hospitalar de Lisboa Norte, Lisbon, Portugal.
GE Port J Gastroenterol. 2017 May;24(3):137-141. doi: 10.1159/000450899. Epub 2016 Dec 9.
Sarcoidosis involving the digestive tract is very rare and requires a strict differential diagnosis with other systemic granulomatous diseases. We present a case of multisystemic granulomatosis involving the stomach and colon, causing initial digestive symptoms. Pulmonary nodules, pleural effusion, ascites, hepatomegaly, splenomegaly, and mesenteric as well as retroperitoneal and axillary lymphadenopathy were subsequently identified. The reticulo-endothelial expression, the hypercalcemia and, above all, a rapid and complete resolution after corticosteroids supported the hypothesis of sarcoidosis involving the digestive tract. A brief review of digestive tract involvement in sarcoidosis and of the distinctive features of sarcoidosis with gastrointestinal involvement and Crohn's disease with a rare form of pleuro-pulmonary involvement is presented.
累及消化道的结节病非常罕见,需要与其他系统性肉芽肿性疾病进行严格的鉴别诊断。我们报告一例多系统性肉芽肿病累及胃和结肠,最初表现为消化道症状。随后发现有肺结节、胸腔积液、腹水、肝肿大、脾肿大以及肠系膜、腹膜后和腋窝淋巴结病。网状内皮细胞表达、高钙血症,尤其是使用皮质类固醇后迅速且完全缓解,支持了结节病累及消化道的假说。本文简要回顾了结节病累及消化道的情况,以及结节病合并胃肠道受累与克罗恩病合并罕见胸膜肺受累的独特特征。