Sarcoidosis with Multiple Organ Involvement-A Case Report

Purpose: To present a case of sarcoidosis with multiple organ involvement. Methods: An observational case report Results: A 27-year-old female experienced bilateral uveitis. Three month later, she suffered from chest tightness and computed tomography (CT) scan revealed enlargement of lymph nodes in mediastinal, hilar and subcarinal region. Mediastinoscopic biopsy was performed, which disclosed non-caseating granulomatous inflammation. Diagnosis of sarcoidosis was made after excluding other granulomatous diseases. Nine months later, histopathologic finding of multiple palpable masses over her right neck revealed lymphoadenopathy with non-caseating granulomatous inflammation. Parotid gland involvement was also confirmed by sono-guide biopsy. During the four-year follow up period, the patient suffered from several episodes of abdominal pain, chest tightness headache and arthralgia constantly despite continuous immunosupressent therapy including oral steroid and cyclosporine-A. Uveitis recurred three times during this period. At the end of the follow up, cells were noted in anterior chamber of both her eyes and the best-corrected visual acuity was 6/8.6 in her right eye and 6/12 in her left eye. Conclusions: Sarcoidosis is a systemic chronic inflammatory process which can involve many organs and present with various symptoms. Herein, we present a case of sarcoidosis initially involving the eyes, followed by involving intra-and extrathoratic lymph nodes, central nerve system (CNS), musculoskeletal system, skin, as well as parotid gland, which occurs only about in 10% of patients with sarcoidosis, and has never been reported in Taiwan before.