Case Report: Rare, Symptomatic Gastrointestinal Sarcoidosis

Patient with previous neurological, bone and hematologic involvement presents with hematemesis

A 59-year-old African American male with a past medical history of biopsy-proven sarcoidosis with neurological, bone and hematologic involvement presented with upper gastrointestinal bleeding and acute blood loss anemia. His sarcoidosis had been in remission since 2012 after previous treatment with methotrexate. 

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He was admitted to the medical intensive care unit with hematemesis and continued to rebleed despite multiple esophagogastroduodenoscopies and embolizations and ultimately required more than 50 units of packed red blood cells. He ultimately underwent a total gastrectomy, splenectomy and esophagojejunal anastomosis with J-tube, with another massive bleed after surgery. Watch to find out how physicians established the difficult diagnosis of systemic sarcoidosis.

Dr. Yedimenko is staff in the Department of Rheumatologic and Immunologic Diseases.