A symptomatic gastric sarcoidosis and asymptomatic pulmonary sarcoidosis: a rare manifestation

Abstract

Sarcoidosis is a granulomatous disease of unknown etiology which may present with systemic manifestations. The diagnosis of gastric sarcoidosis needs much effort to accomplish as it is exceedingly rare, and the treatment is usually recommended exclusively for symptomatic disease. Here, we present a case of gastric sarcoidosis in a 31-year old black female patient with symptoms of nausea and epigastric pain. A diagnosis of gastric sarcoidosis was mainly based on the presence of non-necrotizing granulomas on biopsy following esophagogastroduodenoscopy (EGD). She was treated with steroid with high dose at first, followed by a slow taper and the symptoms responded to the treatment.

Subhepatic Abscess Unmasking the Silent Gastric and Pulmonary Sarcoidosis

“…Gastric sarcoidosis is an uncommon and often asymptomatic condition whose signs and symptoms may resemble other GI diseases. This is responsible for late diagnosis and hence delay in treatment initiation [ 5 ]. Gastric sarcoidosis is unique as it can mimic other etiologies of granulomatous gastritis, including Crohn’s disease, Whipple’s disease, hypertrophic gastritis, infections like Helicobacter pylori, syphilis, histoplasmosis, tuberculosis, Langerhans cell histiocytosis, and malignancies like lymphoma and adenocarcinoma [ 6 , 7 ].…”

“…Weight loss can raise clinical suspicion of malignancy. Endoscopic biopsy is considered the gold standard for making a diagnosis of gastric sarcoidosis [ 5 ].…”

Uncommon Types of Gastritis and Gastropathies Including Anti-parietal Cell, GVHD, Reactive and Granulomatous Gastritis

“…19.5d). Other rare non-infectious causes of GG include tumorous conditions (adenocarcinoma and MALT lymphoma), vasculitides, eosinophilic granulomatosis, polyangiitis, drugs like cocaine, carbimazole and interferon, xanthogranulomatous gastritis, foreign body reactions to stomach contents within an ulcer repair zone or to surgical material (suture granuloma), crystalline drugs (antacids containing magnesium, aluminium and silicon), reaction to endogenous materials (mucin, lipid or crystalline material), Langerhans cell histiocytosis (more common in children) and chronic granulomatous disease (more common in childhood and adolescence) [61][62][63][64][65][66][67][68][69][70]. Clinically apparent gastritis is seen in 2 to 7 percent of CD patients, microscopic involvement may be seen in up to 75 percent of patients in a normal appearing mucosa endoscopically [60].…”

“…The gastric mucosa may show nodular and thicken gastric mucosal folds, erosion, ulcers or polypoidal lesion obstructing gastric outlet. Infiltrative and hyperplastic mucosa may mimic Ménétrier's disease or linitis plastica [68,69].…”