doiSerbia

Mystery called sarcoidosis: Forty-four years follow-up of chronic systemic disease

Škodrić-Trifunović Vesna (Medicinski fakultet, Beograd + Klinika za pulmologiju, Klinički centar Srbije, Beograd)
Vučinić Violeta (Medicinski fakultet, Beograd + Klinika za pulmologiju, Klinički centar Srbije, Beograd)
Simić-Ogrizović Sanja (Medicinski fakultet, Beograd + Klinika za nefrologiju, Klinički centar Srbije, Beograd)
Stević Ruža (Medicinski fakultet, Beograd + Centar za radiologiju i magnetnu rezonancu, Klinički centar Srbije, Beograd)
Stjepanović Mihailo (Klinika za pulmologiju, Klinički centar Srbije, Beograd)
Ilić Katarina (Farmaceutski fakultet, Katedra za farmakologiju, Beograd)
Savić Živorad (Centar za radiologiju i magnetnu rezonancu, Klinički centar Srbije, Beograd)

Introduction. This is a presentation of a 61-year-old female patient. Since 44 years have passed from the onset of her first symptoms until the final diagnosis of sarcoidosis, this was the reason of our decision to publish the case. Case Outline. During the follow-up period of 44 years the patient had ocassional polymorphic complains, such as adynamia, nausea, abdominal pains, myalgia, arthralgia, body weight loss (8-10 kg) etc. The clinical course was predominated by splenomegaly, hepatitis and arthralgia, and later chronic renal failure also developed. Laboratory findings showed elevated markers of acute inflammation and autoantibodies. The patient was hospitalized in different university internal hospitals (gastroenterology, allergology, rheumatology, nephrology and pulmology). Liver biopsy was performed three times, rectum and kidney biopsy once each and finally bronchoscopy and pulmonary biopsy was done. At last, about 40 years from the onset of the first symptoms, in 2006 the diagnosis of lung sarcoidosis was established. Conclusion. The final diagnosis of spleen sarcoidosis was confirmed by pathologically verified sarcoidosis of the lungs. This case is particularly interesting because of the presence of familial sarcoidosis (the patient’s son also had recurrent pulmonary sarcoidosis).

Keywords: sarcoidosis, liver, spleen, lung, kidney

Projekat Ministarstva nauke Republike Srbije, br. 175046