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Gastrointestinal Sarcoidosis


Presentation

  • Abstract A patient with long-standing sarcoidosis was found to have jejunal atrophy and nonnecrotizing granulomas of the stomach, small bowel, and colon when she presented with malabsorption.[ncbi.nlm.nih.gov]
  • The patient symptomatically improved but 5 mo later presented with abdominal pain caused by perforation of the cecum. He underwent a cecectomy and pathology revealed pneumatosis cystoides intestinalis.[ncbi.nlm.nih.gov]
  • Diagnosis of sarcoidosis may be difficult, especially if no other typical features are present.[journals.lww.com]
  • Gastric sarcoidosis affects approximately 10% of patients with systemic disease and only rarely presents with symptoms. Here we present the case of a bleeding gastric ulcer in a 66-year-old female with pulmonary sarcoidosis.[elsevier.es]
Weight Loss
  • The first case was an 8-year-old Saudi girl who presented with fever, weight loss, and abdominal pain that was followed in a few months with hematemesis and development of hepatosplenomegaly.[ncbi.nlm.nih.gov]
  • Abstract A 39-year-old male reported fevers, weight loss, watery loose stools, and decreased visual acuity in his right eye over the prior five years.[ncbi.nlm.nih.gov]
  • Despite compliance with treatment and proper dosing, the patient persisted to be febrile with further weight loss.[saudijgastro.com]
  • Here, we describe a case of gastrointestinal sarcoidosis in a 37-year-old male with symptoms of weight loss, fever, and abdominal pain.[ekjm.org]
  • The symptoms of Inflammatory bowel disease include:: Blood in stool , Rectal bleeding , Diarrhea , Fever , Tender abdomen , Bowel obstruction , Constipation , Fatigue, Abdominal pain, Abdominal mass , Unintentional weight loss , Left lower abdominal pain[healthtap.com]
Fishing
  • It also includes lean meats, poultry, fish, beans, and fat-free or low-fat milk or milk products. Drink plenty of fluids , enough so that your urine is light yellow or clear like water.[gis.md]
Pathologist
  • Uses expanded tables to outline specific differential diagnostic points helpful for surgical pathologists. Discusses the key molecular aspects of tumor progression and risk assessment in all chapters that cover neoplastic disorders.[books.google.es]
Short Stature
  • Considering the steroid dependency of the disease and the short stature of the patient, he was commenced on infliximab 5 mg/kg administered intravenously at 0, 2 and 6 weeks and then every 8 weeks.[saudijgastro.com]
Vomiting
  • The second case was a 9-year-old Sudanese boy who manifested with vomiting, epigastric pain, and weight loss. On upper endoscopy, both cases demonstrated severe erosive nodular gastric mucosa.[ncbi.nlm.nih.gov]
  • Other symptoms are nausea, vomiting, bloating, and early satiety.[elsevier.es]
Nausea
  • Michele initially had lots of gastric and epigastric burning pain; also lots of nausea (associated w/ dizziness, cold sweats). the pain was resolved after i had a course of biaxin, nausea is controlled by large doses of neurontin. probably all depends[inspire.com]
  • Other symptoms are nausea, vomiting, bloating, and early satiety.[elsevier.es]
  • None of them had diarrhea. 3 Our patient presented without epigastric pain but his presenting symptoms were nausea and diarrhea.[academic.oup.com]
Vascular Disease
  • Aronson PJ, Fretzin DF, Morgan NE (1985) A unique case of sarcoidosis with coexistent collagen vascular disease. Possible result of a compatible disease-sustaining immunologic environment.[link.springer.com]
  • Coronary Artery Disease or Peripheral Vascular Disease No change in standard management. E. Diabetes or other Endocrine issues Hyperglycemia due to steroid use – titrate up antidiabetics.[cancertherapyadvisor.com]

Workup

  • Given the multisystem involvement with significant chest findings, tissue findings of granulomatous disease, and negative workup for other causes of granulomatous inflammation, both cases were diagnosed with active disseminated sarcoidosis, and treated[ncbi.nlm.nih.gov]
  • Provides all the necessary tools to make a comprehensive diagnostic workup including data from ancillary techniques and molecular findings whenever appropriate.[books.google.es]
  • An extensive workup was performed and auto-antibody screening was negative. A capillaroscopy of the nail bed according to the suspicion of SSc was positive for advanced SSc and an esophageal manometry showed 30% of non-transmitted waves.[scielo.isciii.es]
  • The combination of sarcoidlike histological findings in the lungs, esophagus and large intestine, lack of characteristic inflammatory bowel disease histological findings and negative workup for infectious disease of the lungs and the gastrointestinal[journals.lww.com]
Macrocytosis
  • Throughout the 4-year follow up, the course of the disease was punctuated by several relapses on tapering of corticosteroids and later development of vitamin B 12 deficiency anemia: hemoglobin 10.6 gm/dL, macrocytosis (MCV 102, normal 80-91 fL), hyperchromasia[saudijgastro.com]
Tropheryma Whipplei
  • Angiotensin-converting enzyme (ACE) was elevated at 77 U/L, and rapid plasma reagin and Tropheryma whipplei testing were negative. Figure 2. EGD showing moderately erythematous mucosa at the pylorus.[acgcasereports.gi.org]
  • Angiotensin-converting enzyme (ACE) was elevated at 77 U/L, and rapid plasma reagin and Tropheryma whipplei testing were negative.[ncbi.nlm.nih.gov]

Treatment

  • Symptoms of malabsorption rapidly abated with corticosteroid treatment given for severe pulmonary disease. Gastrointestinal sarcoidosis was clearly established, although coincident celiac sprue could not be excluded.[ncbi.nlm.nih.gov]
  • The patient's course was favorable after treatment with prednisone and chlorambucil. Disseminated gastrointestinal sarcoidosis may be a previously unidentified cause of protein-losing enteropathy.[ncbi.nlm.nih.gov]
  • Author information 1 Department of Respiratory Medicine, Japanese Red Cross Medical Center, Japan. inomataminoru@nms.ac.jp Abstract Involvement of the upper gastrointestinal tract in sarcoidosis is rare, and an optimal treatment regimen remains to be[ncbi.nlm.nih.gov]
  • Incorporate the latest findings and improvements in care for liver disease patients —from diagnosis and treatment through post-treatment strategies and management of complications. Expert Consult eBook version included with purchase.[books.google.es]
  • It also highlights some of the other disease associations such as with other biliary tract disorders and provides information on treatments, particularly the role of biologic therapies.[ncbi.nlm.nih.gov]

Prognosis

  • Prior reports on cancer related sarcoidosis are inconsistent in terms of prognosis; while some reports link sarcoidosis with a favorable prognosis, others associate it with recurrence and secondary malignancies.[ascopubs.org]
  • Seite 117 - Pulmonary sarcoidosis: role of CT in the evaluation of disease activity and functional impairment and in prognosis assessment. Radiology 191 (3): 675-680 141. ‎[books.google.de]
  • TREATMENT AND PROGNOSIS The prognosis of sarcoidosis is good in most patients. The majority of patients with acute disease recover completely. Those patients who do have residual damage of affected organs usually have only minimal organ dysfunction.[meddean.luc.edu]
  • Prognosis and Patient Counseling. Generally, a good prognosis. Less than 5% of patients die of sarcoidosis, with neurosarcoidosis and cardiac sarcoidosis being the main causes of death.[cancertherapyadvisor.com]

Etiology

  • The etiology of pneumatosis cystoides intestinalis in this case was likely multifactorial and involved both effects of the corticosteroids as well as the advanced nature of the gastrointestinal sarcoidosis.[ncbi.nlm.nih.gov]
  • A case-control etiologic study of sarcoidosis (ACCESS). Am J Respir Crit Care Med. 2001; 164(Suppl 11):2085-2091. Rybicki BA, Major M, Popovich J Jr., Maliarik MJ, Iannuzzi MC.[smartscitech.com]
  • ABSTRACT Sarcoidosis is a multisystemic granulomatous disease of unknown etiology that is based on the presence of non-caseating granulomas. Sarcoidosis commonly involves the lungs, skin, and eyes.[ekjm.org]
  • Keywords: Sarcoidosis, gastrointestinal sarcoidosis, symptomatic gastric sarcoidosis, extra pulmonary sarcoidosis Texto Completo Introduction Sarcoidosis is a systemic granulomatous disease of unknown etiology that is characterized by the formation of[elsevier.es]

Epidemiology

  • KW - Epidemiology KW - Gastrointestinal disease KW - Sarcoidosis UR - UR - M3 - Article VL - 35 JO - Sarcoidosis Vasculitis and Diffuse Lung Diseases JF - Sarcoidosis Vasculitis and Diffuse Lung Diseases SN - 1124-0490 IS - 3 ER -[mayoclinic.pure.elsevier.com]
  • Introduction Definition a systemic inflammatory disease that is characterized by the presence of non-caseating granulomas Epidemiology incidence the lung is most commonly involved most common in African Americans Etiology unknown Pathogenesis macrophages[step2.medbullets.com]
  • In light of the strong epidemiological exposure, antituberculous medications were initiated (combination of isoniazid, pyrazinamide, ethambutol, and refampicin).[saudijgastro.com]
  • Epidemiology of sarcoidosis in Japan . Eur Respir J 2008; 31 :372–379. [ PubMed ] [ Google Scholar ] 5. Farman J, Ramirez G, Rybak B, et al. Gastric sarcoidosis . Abdom Imaging 1997; 22 :248–252. [ PubMed ] [ Google Scholar ] 6.[ncbi.nlm.nih.gov]
Sex distribution
Age distribution

Pathophysiology

  • Unlike others on this topic, this text demonstrates how the endoscope incorporates pathophysiology, diagnostic, and treatment modalities into endoscopic practice.[books.google.es]
  • Analyses of gastrointestinal, oropharyngeal, lung and blood specimens will improve the understanding of H. pylori, VacA toxin, and other toxins as well as their potential role in pathophysiology of disease.[clinicaltrials.gov]
  • After I had thoroughly researched the mechanisms of action of LDN, I began prescribing it to patients who had inflammation as part of the pathophysiology of their conditions (Crohn's disease, ulcerative colitis, post-infectious IBS) and I saw good responses[ldnscience.org]
  • No other association was found between the diseases, which seem to have a different pathophysiology, which agrees with the differences in clinical presentation.[ncbi.nlm.nih.gov]

Prevention

  • Early recognition and prompt treatment are important to prevent irreversible renal complications.[jamanetwork.com]
  • Special chapters, such as the Designing Clinical Research in Gastrointestinal Endoscopy, The Prevention of Infection Following Gastrointestinal Endoscopy, Complications of Peptic Ulcer Disease, and Credentialing for Gastrointestinal Endoscopy, help make[books.google.es]
  • NYU Langone doctors manage the condition, helping to prevent any long-term complications. Treatment at NYU Langone Treatment for sarcoidosis depends on the severity and duration of the disease.[nyulangone.org]
  • Also, it indicates that early recognition of sarcoidosis and consideration of pulmonary sarcoidosis as a differential of tuberculosis may prevent the devastating and serious complications. References 1. Ebert EC, Kierson M, Hagspiel KD.[jdeonline.in]
  • Appropriate Prophylaxis and Other Measures to Prevent Readmission. Deep vein thrombosis (DVT) prophylaxis to follow the general recommendations for hospitalized medical patients.[cancertherapyadvisor.com]

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