Gastroduodenal Sarcoidosis: A Case Report

Sarcoidosis is a systemic granulomatous disease of unknown etiology. Sarcoidosis involving the gastrointestinal (GI) tract is extremely rare. This is a rare case report of an individual with symptomatic gastroduodenal sarcoidosis. A 34-year-old male with a six-month history of epigastric pain, nausea, early satiety and weight loss presented to our clinic. An upper endoscopy was performed which showed a cardia ulcer that measured approximately 10 mm along with multiple superficial erosions and patchy erythema in all parts of the gastroduodenal mucosa. Biopsies of the stomach and duodenum revealed severe active chronic noncaseating granulomatous gastritis and duodenitis. Stains for Helicobacter pylori, acid fast bacteria, and fungi were negative. An upper GI series showed thickened gastric folds with narrowing of the gastric body and antrum with lack of distensibility. The plasma level of angiotensin converting enzyme (ACE) was elevated. Corticosteroid therapy was started with rapid abatement of his symptoms. In cases of refractory epigastric pain, especially if other organ involvement, gastroduodenal sarcoidosis should be considered.