부산대학교 도서관

Sarcoidosis is a chronic multisystemic granulomatous disease that predominantly involves the thoracic lymph nodes and lungs and primarily occurs in young adults. Isolated extrapulmonary localization is uncommon in adults, and exceptionally rare in the pediatric age group. A 4-year-old male patient with chronic diarrhea and abdominal distention for the last 8 months is presented. Endoscopic biopsies, obtained during gastroscopy and colonoscopy, revealed noncaseating granulomas in all segments of the gastrointestinal tract. A noncaseating granuloma was also demonstrated in the liver biopsy. Granulomatous inflammation of both the gastrointestinal system and liver along with elevated serum angiotensin-converting enzyme were consistent with sarcoidosis. The peculiarity of our pediatric sarcoidosis was the involvement of whole gastrointestinal system, which is exceptionally rare in all age groups. Furthermore, this is the youngest case in the literature with gastrointestinal and hepatic sarcoidosis in the absence of pulmonary involvement at onset. Keywords: Extra-pulmonary involvement, intestine, liver, pediatric sarcoidosis, stomach Sarkoidoz, agirhkh olarak torasik lenf nodlan ve akcigerleri tutan bir kronik multisistemik graniilomatoz hastahktir ve cogunlukla gene eriskinlerde gorulur. Izole ekstrapulmoner tutulum eriskinlerde sik goriilmemekle birlikte gocukluk yas grubunda cok daha nadirdir. Son 8 aydir kronik ishal ve abdominal distansiyonu olan 4 yasinda bir erkek hasta sunuldu. Gastroskopi ve kolonoskopide alinan biyopsilerde, gastrointestinal sistemin turn segmentlerinde nonkazeifiye graniilomlar tespit edildi. Aynca, karaciger biyopsisinde de nonkazeifiye granulom saptandi. Hem gastrointestinal sistemin hem de karacigerin graniilomatoz inflamasyonu, anjiotensin-donusturucu enzim yiiksekligi ile birlikte degerlendirildiginde sarkoidoz ile uyumlu goruldu. Pediatrik sarkoidoz olgumuzun en onemli ozelligi, turn yas gruplannda son derece nadir goriilen gastrointestinal sistem tutulumunun vakamizda yaygin olarak saptanmasiydi. Aynca bu olgu baslangigta akciger tutulumu olmadan, gastrointestinal ve hepatik tutulumun birlikte goruldugu dizindeki en geng olgudur. Anahtar sozcukler: Bagirsak, ekstra pulmoner tutulum, karaciger, mide, pediatrik sarkoidoz
Introduction Sarcoidosis is a multisystem inflammatory disorder of unknown etiology that manifests with noncaseating epitheloid granulomas predominantly in the thoracic lymph nodes and lungs. The most common extra-pulmonary presentation in [...]