Sarcoidosis presenting with splenomegaly and abdominal pain: a case report

Sarcoidosis is a multisystemic disease of unknown aetiology characterized by proliferation of noncaseating granulomas at disease sites. It commonly affects young and middle-age adults and frequently presents with pulmonary infiltration, bilateral hilar lymphadenopathy, ocular and skin lesions. The liver, spleen, lymph nodes, salivary glands, heart, nervous system, muscles, bones, and other organs may also be involved. A diagnosis of the disorder usually requires the demonstration of typical lesions in more than one organ system and exclusion of other disorder known to cause granulomatous inflammation. We present the case of a young woman with abdominal pain and weight loss. The finding of splenomegaly by abdominal ultrasound and the presence of hypercalciuria, hypercalcemia and mild renal impairment led us to include sarcoidosis in the differential diagnosis. The final diagnosis was established by demonstration of involvement of lymph nodes and lung parenchyma on CT scan, and typical histology in bioptic specimens collected from bronchial mucosa.