Abstract
Sarcoidosis is a systemic granulomatous disease of unknown etiology that is characterized by the formation of noncaseating granulomas. Gastrointestinal (GI) tract involvement in sarcoidosis is rare. Gastric sarcoidosis, particularly involving the antrum, affects approximately 10% of patients with systemic disease. GI sarcoidosis commonly occurs subclinically, with clinical manifestations present in only 0.1–0.9% of patients with the disease.This is a rare case report of a 8year Saudi girl with symptomatic gastric sarcoidosis. The patient presented with anorexia, postprandial upper abdominal pain and fullness, and weight loss of 3months duration. She was presented acutely after 6months with attack of hematemesis. Endoscopic examination of upper gastrointestinal tract revealed bleeding nodular mucosal irregularities. Mucosal biopsies revealed noncaseating granulomatous inflammation involving the gastric mucosa confirming the diagnosis of sarcoidosis. Corticosteroid therapy was started and the symptoms abated almost immediately. We also offer a review of the literature.
Highlights
Sarcoidosis is a disease of undetermined cause that primarily affects adults and is characterized by the formation of noncaseating granulomas
The etiology of sarcoidosis is unknown, most experts think that sarcoidosis results from the exposure of genetically susceptible hosts to specific environmental, occupational or infectious agents that trigger an exaggerated cellular immune response, leading to granuloma formation
This is a rare case report of a 8 year Saudi girl with symptomatic gastric sarcoidosis presented with anorexia, upper abdominal pain, weight loss of 3 months duration, and 6 months later presented with hematemesis and abated almost immediately with corticosteroid treatment
Summary
Sarcoidosis is a disease of undetermined cause that primarily affects adults and is characterized by the formation of noncaseating granulomas. Follow-up studies on chromosome 6 identified the BTNL2 gene to be associated with sarcoidosis [2] This is a rare case report of a 8 year Saudi girl with symptomatic gastric sarcoidosis presented with anorexia, upper abdominal pain, weight loss of 3 months duration, and 6 months later presented with hematemesis and abated almost immediately with corticosteroid treatment. A Saudi girl (8 years old) presented with 3 month history of anorexia, post prandial upper abdominal pain and fullness She was complaining of generalized fatigue, early satiety, paleness and weight loss of 5 kg in last 3 months. Stains for Helicobacter pylori, acid fast, and fungi were negative, serum angiotensin converting enzyme was 74 units/l (N 44–125 units/L), 24 h urine collection ruled out hypercalciuria She was treated with prednisolone, metoclopramide, and antacid and obtained relief of gastric symptoms, noted weight gain and improvement in her energy level. The dose of prednisolone was gradually tapered to a maintenance dose of 10–15 mg over a period of approximately 6 months, upper gastrointestinal barium study performed later showed a decrease in gastric nodularity
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