Sarcoid and IBD

Q: Sarcoidosis seems to have a greater tendency to exist with which of the following gastrointestinal immune/inflammatory disorders? - select one

A) Crohn disease

B) Ulcerative colitis

Answer: A

Bronchoalveolar lavage fluid lymphocytosis, elevated CD4/CD8 lymphocyte ratios, and nonnecrotizing granulomas in the lungs can be seen in both disorders, suggesting a possible common pathogenic mechanism between the two diseases. 

It is important to differentiate between coexistence of both disorders from pure intestinal sarcoidosis. Other manifestations of Crohn disease include pyoderma gangrenosum, rectal and perianal lesions, and enterocutaneous fistulas. Also, intestinal sarcoidosis usually involves only the mucosa, whereas Crohn disease can be transmural, with crypt inflammation, aphthae, and ulcers.

The concurrence of sarcoidosis and ulcerative colitis is rare.

#GI

References:

1. Mitchell DN, Rees RJ. Sarcoidosis and Crohn's disease. Proc R Soc Med 1971; 64:944.

2. D'Ercole C, Zullo A, Bragazzi MC, Campo SM. Sarcoidosis and coeliac disease: do not forget the association! Intern Emerg Med 2012; 7 Suppl 1:S25.

3. Mills K, Fatima S, Fas N. Crohn's Disease Diagnosed in a Man with Sarcoidosis: Coincidence or Correspondence? Case Rep Gastrointest Med. 2022 May 27;2022:5943468. doi: 10.1155/2022/5943468. PMID: 35669381; PMCID: PMC9166977.