Year 2025 / Volume 117 / Number 7
Letter
Sarcoidosis with esophageal involvement: an uncommon clinical enigma

404-405

DOI: 10.17235/reed.2024.10436/2024

Macarena Torres-Larrubia, Sergio Casiano-Manzano, Alberto Masa-Caballero, Zuliani Jiménez-Colmenarez, Miguel Fernández-Bermejo, Pablo Solís-Muñoz,

Abstract
We present the case of a 46-year-old male, a former smoker, with a medical history significant for morbid obesity grade III, hypothyroidism, hyperuricemia, and dyslipidemia. Four months ago, he was diagnosed with sarcoidosis involving mediastinal lymph nodes and is currently undergoing treatment with corticosteroids. The patient presented to the emergency department with persistent epigastric and thoracic pain lasting one week, accompanied by dysphagia and odynophagia intermittently. Laboratory tests showed elevated acute-phase reactants, with no other notable abnormalities. Chest X-ray revealed pre-existing mediastinal adenopathy. Despite an abdominal CT scan with contrast showing no significant findings, esophagogastroduodenoscopy revealed marked extrinsic compression of the esophagus between 25 and 32 cm from the dental arch, with less intensity distally. Although passage of the endoscope through this area caused significant pain, it did not hinder its advancement. A chest CT scan with oral contrast demonstrated filamentous narrowing of the esophagus in the middle third, along with concentric thickening of its walls and multiple paratracheal, parahilar, and periesophageal lymphadenopathies. Following a tapering regimen of corticosteroids, the patient was discharged with a clinical diagnosis of sarcoidosis with mediastinal and esophageal involvement secondary to extrinsic compression. Due to clinical improvement with the prescribed treatment, endoscopic ultrasound and biopsies to assess esophageal wall involvement were deemed unnecessary.
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References
Vahid B, Spodik M, Braun KN, et al. Sarcoidosis of gastrointestinal tract: a rare disease. Dig Dis Sci. 2007;52(12):3316-3320. doi:10.1007/s10620-006-9448-y
Bani Fawwaz B, Farooq A, Al-Dwairy A, et al. Dysphagia: A Rare Presentation of Sarcoidosis. Cureus. 2021 Nov; 13(11): e19397. DOI: 10.7759/cureus.19397
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Torres-Larrubia M, Casiano-Manzano S, Masa-Caballero A, Jiménez-Colmenarez Z, Fernández-Bermejo M, Solís-Muñoz P, et all. Sarcoidosis with esophageal involvement: an uncommon clinical enigma. 10436/2024


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Publication history

Received: 27/03/2024

Accepted: 16/04/2024

Online First: 30/04/2024

Published: 08/07/2025

Article Online First time: 34 days

Article editing time: 468 days


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