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Journal of Case Reports
Multidisciplinary Approach: An Essential Step in Diagnosing Granulomatous Disease
V. Sujanitha1, T. Kumanan1, G Selvaratnam1, S. Giridaran2
Departments of 1Medicine, Teaching Hospital, Jaffna, Sri Lanka; 2Consultant Surgeon, Base Hospital, Jaffna, Sri Lanka.
Corresponding Author:
Dr. V. Sujanitha
Email: sujanitha@yahoo.com
Received: 24-AUG-2017 Accepted: 4-DEC-2017 Published Online: 05-DEC-2017
DOI: http://dx.doi.org/10.17659/01.2017.0105
Abstract
Background: Abdominal lymphadenopathy is a common presentation of many diseases and sarcoidosis should be considered as an important differential diagnosis. Prompt early diagnosis would help to minimize the disease progression and its complications. Case Report: A 51 year old female presented with appetite and weight loss of seven months duration and found to have an intra-abdominal lymphadenopathy. A celiac axis lymph node biopsy showed granulomatous lymphadenitis and the patient quickly progressed to develop hepato-splenomegaly with CT evidence of multiple attenuation areas in spleen, intra-pulmonary nodules with lymphadenopathy. An endo-bronchial biopsy also confirmed a non-necrotizing granulomatous inflammation. Patient had a remarkable improvement in symptoms with oral steroids. Conclusion: Intra-abdominal lymphadenopathy, an initial presentation of many common diseases has heterogeneous etiology and sarcoidosis is one important clinical diagnosis. Appropriate use of available investigations and careful regular clinical assessment with multi-disciplinary approach to identify new organ involvement will help to arrive at early diagnosis and treatment.
Keywords : Biopsy, Lymphadenopathy, Lymphadenitis, Sarcoidosis, Tuberculosis.
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