Dörfler H, Conca W, Remberger K
Klin Wochenschr. 1986 Oct 31;64(21):1139-43. doi: 10.1007/BF01726876.
A 42-year-old man had a 4 year history of sarcoidosis stage II (lung). In biopsied specimens of the antrum we found epithelioid granulomas caused by gastric involvement in sarcoidosis. Coincidentally we found a gastric ulcer which was later the source of gastric bleeding. The granulomas were located around this ulcer and also under intact mucosa. Therefore, in our opinion it was not the case that granulomatous gastritis caused the ulceration in a direct way. We saw a connection between hypercalcemia--often found in patients with sarcoidosis, as in our patient--and the gastric ulcer. Therapy was thus aimed at lowering the blood calcium concentration. Steroids were avoided at this time. The ulceration healed, although granulomatous gastritis continued.
一名42岁男性有二期结节病（肺部）4年病史。在胃窦活检标本中，我们发现结节病累及胃部导致的上皮样肉芽肿。巧合的是，我们发现了一个胃溃疡，后来它成为胃出血的源头。肉芽肿位于这个溃疡周围以及完整黏膜下方。因此，我们认为并非肉芽肿性胃炎直接导致了溃疡形成。我们发现高钙血症（正如我们这位患者，在结节病患者中经常出现）与胃溃疡之间存在关联。因此治疗旨在降低血钙浓度。此时避免使用类固醇。溃疡愈合了，尽管肉芽肿性胃炎仍持续存在。
