Cigdem Celikel, Burcu Volkan, Özlem Kalaycık Şengül, BİLGE ŞAHİN AKKELLE, Engin Tutar, Deniz Ertem

Erken yaşta malabsorbsiyon ile ortaya çıkan gastrointestinal sarkoidoz olgusu

Sarkoidoz, ağırlıklı olarak torasik lenf nodları ve akciğerleri tutan birkronik multisistemik granülomatöz hastalıktır ve çoğunlukla genç eriş kinlerde görülür. İzole ekstrapulmoner tutulum erişkinlerde sık görül memekle birlikte çocukluk yaş grubunda çok daha nadirdir. Son 8 aydırkronik ishal ve abdominal distansiyonu olan 4 yaşında bir erkek hasta su nuldu. Gastroskopi ve kolonoskopide alınan biyopsilerde, gastrointesti nal sistemin tüm segmentlerinde nonkazeifiye granülomlar tespit edildi.Ayrıca, karaciğer biyopsisinde de nonkazeifiye granülom saptandı. Hemgastrointestinal sistemin hem de karaciğerin granülomatöz inflamasyo nu, anjiotensin-dönüştürücü enzim yüksekliği ile birlikte değerlendiril diğinde sarkoidoz ile uyumlu görüldü. Pediatrik sarkoidoz olgumuzunen önemli özelliği, tüm yaş gruplarında son derece nadir görülen gastro intestinal sistem tutulumunun vakamızda yaygın olarak saptanmasıydı.Ayrıca bu olgu başlangıçta akciğer tutulumu olmadan, gastrointestinalve hepatik tutulumun birlikte görüldüğü dizindeki en genç olgudur.

Gastrointestinal sarcoidosis presenting withmalabsorption at an early age

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.

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