P0230 - A Case of Colonic Sarcoid

Alisa Farokhian, MD¹, Ioannis Economou, MD^2
1Columbia University, New York, NY; ²Northshore, Northshore, IL

Introduction: Sarcoidosis is typically defined as a multisystem granulomatous disease of unknown cause. Although sarcoid is typically seen in the lungs, it’s presentation in other organ systems and often are debilitating. Occasionally sarcoidosis can be seen in the gastrointestinal tract however it is rarely described to be found in the colon. Here we present a case of a 47 yo who presents with both neurosarcoid and complicated with colonic sarcoid.

Case Description/Methods: A 47 year old female with a history of Iron deficiency anemia, fibroid uterus, and recently diagnosed neurosarcoidosis presented with watery diarrhea ongoing for the past 2 months. She has been treated for neurosarcoid with prednisone for the past 2 months after developing bell’s palsy and uveitis. She endorses roughly 8-10 watery non-bloody bowel movements a day. Given the chronicity of diarrhea, the decision was made to proceed with colonoscopy which was relatively benign other than 2 polyps and random biopsies were taken throughout. Pathology was consistent with non-necrotizing granulomatous inflammation in the ascending colon, the transverse colon, the descending colon, and the rectosigmoid. Given her recent diagnosis of neurosarcoidosis, the biopsies have confirmed our suspicion of colonic sarcoidosis.

Discussion: Sarcoidosis, although typically seen in the lungs, can be seen throughout multiple organ systems. Involvement of the gastrointestinal tract however is a unique presentation of sarcoidosis and when it is seen is normally present in the esophagus, stomach, or duodenum. In fact, very few cases of colonic sarcoidosis have been documented. Given that this patient already was on treatment with steroids and had complications decision was made to proceed with infliximab to assess response. There was some improvement with diarrhea with infliximab however developed infusion reaction. She is currently pending an appointment with sarcoid specialist with consideration to switch to adalimumab.



Disclosures:


Alisa Farokhian, MD¹, Ioannis Economou, MD². P0230 - A Case of Colonic Sarcoid, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.