Small intestinal involvement revealing sarcoidosis

Abstract

Sir, Sarcoidosis is an immune-mediated condition affecting multiple organs, especially the lungs, lymph nodes, skin and eyes.1,2 Gastrointestinal involvement is considered to be a rare complication of sarcoidosis, occurring in <10% of the patients during the course of the disease.3,4 We recently observed the interesting case of a patient who developed duodenal involvement as the first manifestation of sarcoidosis. A 36-year-old woman, with unremarkable previous medical history, presented with a 4-month history of asthenia and a 10-kg weight loss; she also complained of abdominal pain, diarrhea and arthralgia. At admission, physical examination demonstrated abdominal pain to palpation, involving the epigastric area; general physical examination was otherwise normal. Laboratory findings disclosed the following: erythrocyte sedimentation rate 66 mm/h; C-reactive protein 25 mg/l; hemoglobin 12 g/dl; white blood cell count 9.1 × 109/l; and platelet count 450 × 109/l. Other routine biochemical tests, including renal and liver tests, vitamin B12 and folic acid blood levels, as well as blood and urinary protein immunoelectrophoresis, were normal. …