Sarcoidosis with Rare Extrapulmonary Involvement
Sarcoidosis is a systemic granulomatous disease in which medullary involvement is a rare extrapulmonary manifestation. We present the case of a 37-year-old man with right abdominal and dorso-lumbar pain lasting for months. Computerized tomography showed renal microlithiasis and retroperitoneal, hila...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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SMC MEDIA SRL
2021-07-01
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| Series: | European Journal of Case Reports in Internal Medicine |
| Subjects: | |
| Online Access: | https://www.ejcrim.com/index.php/EJCRIM/article/view/2540 |
| _version_ | 1818716814479196160 |
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| author | Marta Brandão Calçada Sara Montezinho Andreia M Teixeira Bruno Gomes Bernardo Macedo |
| author_facet | Marta Brandão Calçada Sara Montezinho Andreia M Teixeira Bruno Gomes Bernardo Macedo |
| author_sort | Marta Brandão Calçada |
| collection | DOAJ |
| description | Sarcoidosis is a systemic granulomatous disease in which medullary involvement is a rare extrapulmonary manifestation. We present the case of a 37-year-old man with right abdominal and dorso-lumbar pain lasting for months. Computerized tomography showed renal microlithiasis and retroperitoneal, hilar and mediastinal adenopathies. Laboratory results showed an elevated erythrocyte sedimentation rate, IgG, ?2-microgobulin and angiotensin-conversion enzyme, serum calcium in the upper limit and hypercalciuria. There was a slight elevation of the CD4/CD8 ratio in bronchoalveolar lavage, without lymphocytic alveolitis. An endobronchial ganglion biopsy was inconclusive. A positron emission tomography scan demonstrated supra and infra-diaphragmatic, splenic and medullary involvement, suggesting lymphoproliferative disease (LPD). A bone marrow biopsy (BMB) revealed sarcoid-like epithelioid cell granulomas, excluding LPD. Sarcoidosis was assumed and corticosteroids were started. Although cytopenias were not present, the extensive ganglion, splenic and medullary involvement made LPD exclusion imperative, while BMB allowed for a definitive diagnosis. |
| first_indexed | 2024-12-17T19:25:14Z |
| format | Article |
| id | doaj.art-05e945784cfc40ce84c9edd638dc2431 |
| institution | Directory Open Access Journal |
| issn | 2284-2594 |
| language | English |
| last_indexed | 2024-12-17T19:25:14Z |
| publishDate | 2021-07-01 |
| publisher | SMC MEDIA SRL |
| record_format | Article |
| series | European Journal of Case Reports in Internal Medicine |
| spelling | doaj.art-05e945784cfc40ce84c9edd638dc24312022-12-21T21:35:23ZengSMC MEDIA SRLEuropean Journal of Case Reports in Internal Medicine2284-25942021-07-0110.12890/2021_0025402156Sarcoidosis with Rare Extrapulmonary InvolvementMarta Brandão Calçada0Sara Montezinho1Andreia M Teixeira2Bruno Gomes3Bernardo Macedo4Internal Medicine Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PortugalInternal Medicine Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PortugalInternal Medicine Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PortugalInternal Medicine Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PortugalInternal Medicine Department, Centro Hospitalar de Entre o Douro e Vouga, Santa Maria da Feira, PortugalSarcoidosis is a systemic granulomatous disease in which medullary involvement is a rare extrapulmonary manifestation. We present the case of a 37-year-old man with right abdominal and dorso-lumbar pain lasting for months. Computerized tomography showed renal microlithiasis and retroperitoneal, hilar and mediastinal adenopathies. Laboratory results showed an elevated erythrocyte sedimentation rate, IgG, ?2-microgobulin and angiotensin-conversion enzyme, serum calcium in the upper limit and hypercalciuria. There was a slight elevation of the CD4/CD8 ratio in bronchoalveolar lavage, without lymphocytic alveolitis. An endobronchial ganglion biopsy was inconclusive. A positron emission tomography scan demonstrated supra and infra-diaphragmatic, splenic and medullary involvement, suggesting lymphoproliferative disease (LPD). A bone marrow biopsy (BMB) revealed sarcoid-like epithelioid cell granulomas, excluding LPD. Sarcoidosis was assumed and corticosteroids were started. Although cytopenias were not present, the extensive ganglion, splenic and medullary involvement made LPD exclusion imperative, while BMB allowed for a definitive diagnosis.https://www.ejcrim.com/index.php/EJCRIM/article/view/2540bone marrow biopsybone marrow sarcoidosis extrapulmonary sarcoidosissarcoidosis |
| spellingShingle | Marta Brandão Calçada Sara Montezinho Andreia M Teixeira Bruno Gomes Bernardo Macedo Sarcoidosis with Rare Extrapulmonary Involvement European Journal of Case Reports in Internal Medicine bone marrow biopsy bone marrow sarcoidosis extrapulmonary sarcoidosis sarcoidosis |
| title | Sarcoidosis with Rare Extrapulmonary Involvement |
| title_full | Sarcoidosis with Rare Extrapulmonary Involvement |
| title_fullStr | Sarcoidosis with Rare Extrapulmonary Involvement |
| title_full_unstemmed | Sarcoidosis with Rare Extrapulmonary Involvement |
| title_short | Sarcoidosis with Rare Extrapulmonary Involvement |
| title_sort | sarcoidosis with rare extrapulmonary involvement |
| topic | bone marrow biopsy bone marrow sarcoidosis extrapulmonary sarcoidosis sarcoidosis |
| url | https://www.ejcrim.com/index.php/EJCRIM/article/view/2540 |
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