Browsing by Author "Vučinić, Violeta (13410407800)"

Introduction Sarcoidosis is a systemic disease with a 90% predilection for the lungs, but any organ can be involved. Gastric sarcoidosis may be a component of a generalized process, while isolated gastric sarcoidosis is very rare. Case Outline We describe a rare case of biopsy-proven gastric sarcoidosis in a 45-year-old woman with pulmonary sarcoidosis in remission, and highlight the importance of gastroscopy and biopsy to confirm the diagnosis. Her optimal response to anti-acid therapy required no alternate (glucocorticoid) therapy. We briefly review the clinical, diagnostic, and therapeutic aspects of gastric sarcoidosis. Conclusion Glucocorticoids remain the cornerstone of the sarcoidosis treatment, although it has been insufficiently documented by clinical trials. The decision to treat sarcoid patients with systemic glucocorticoids is largely based upon the severity of symptoms. The anti-acid therapy may be an alternative in milder cases, as demonstrated in our patient. © 2017, Serbia Medical Society. All rights reserved.

Introduction: This is a presentation of a 61-year-old female patient. Since 44 years have passed from the onset of her first symptoms until the final diagnosis of sarcoidosis, this was the reason of our decision to publish the case. Case Outline: During the follow-up period of 44 years the patient had ocassional polymorphic complains, such as adynamia, nausea, abdominal pains, myalgia, arthralgia, body weight loss (8-10 kg) etc. The clinical course was predominated by splenomegaly, hepatitis and arthralgia, and later chronic renal failure also developed. Laboratory findings snowed elevated markers of acute inflammation and autoantibodies. The patient was hospitalized in different university internal hospitals (gastroenterology, allergology, rheumatology, nephrology and pulmology). Liver biopsy was performed three times, rectum and kidney biopsy once each and finally bronchoscopy and pulmonary biopsy was done. At last, about 40 years from the onset of the first symptoms, in 2006 the diagnosis of lung sarcoidosis was established. Conclusion: The final diagnosis of spleen sarcoidosis was confirmed by pathologically verified sarcoidosis of the lungs. This case is particularly interesting because of the presence of familial sarcoidosis (the patient's son also had recurrent pulmonary sarcoidosis).

In sarcoidosis, the thyroid and the kidneys are infrequently affected. Clinically recognizable thyroid involvement occurs in < 1% of sarcoidosis patients. Hyperthyroidism, myxodema, and thyroid occur with an equal frequency. It is important to distinguish sarcoidosis of the thyroid from other infections and disorders of the gland. Renal involvement may present as granulomatous infiltration of the renal parenchyma, glomerulonephritis, renal arteritis, and nephrocalcinosis or renal stones. The latter are due to abnormalities of calcium metabolism. Hypercalcemia occurs in about 10 to 13% of sarcoidosis patients; hypercalciuria is three times more frequent. Calcium abnormalities may precede, follow, or occur at any time during the course of sarcoidosis. An endogenous overproduction of 1,25-dihydroxyvitamin D [1,25-(OH 2 )-D 3 ] by granulomatous tissue and activated macrophages results in an increase of intestinal absorption of calcium. Corticosteriods, chloroquine, and hydroxychloroquine subdue 1,25-(OH 2 )-D 3 production and correct hypercalcemia and hypercalciuria.