We
report a 66 year-old
woman with a
history of
pulmonary sarcoidosis, diagnosed with a
lung biopsy in 1993 and treated with
prednisone for 2 years. She presented at our institution in 1999 with a stage IV
disease and important functional and clinical impairment. A bronchial
biopsy disclosed non caseating
granulomas.
Tuberculosis was intensively studied and persistently negative. Due to frequent
nausea and
vomiting an endoscopic gastric
biopsy was performed which revealed non caseating
granulomas involving the
gastric mucosa. There was no evidence of
Helicobacter pylori and
stains for
fungi and
acid-fast bacilli were negative.
Treatment with
prednisone relieved digestive symptoms, although a control
biopsy of the
gastric mucosa revealed persistence of non caseating
granulomas. Both
lung stage IV and gastric
sarcoidosis are uncommon forms of the
disease.