A Young Case of Sarcoidosis Who Developed Subacute Multi-organ Disease Including Bilateral Testis

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A 27-year old man was admitted to our hospital complaining tinnitus, swelling of eye lids, and blurred vision. He was diagnosed as having uveitis by ophthalmologist. In addition, his radiological examination revealed multiple cotton-like shadows with the size of about 2-cm in diameter in both lung fields with mediastinal lymphadenopathy. 67Ga scan showed positive accumulation in the lacrimal gland, parotid gland, mediastinal and hilar lymph nodes, lung field, and in the testis. PPD skin test was negative, serum lysozyme concentration and CD4/CD8 ratio of T cells in bronchoalveolar lavage fluid were elevated. Both specimens obtained by scalene lymph node biopsy and TBLB revealed noncaseating epithelioid cell granulomas, establishing the diagnosis of sarcoidosis. For the treatment of occular lesion, daily dosage of 40mg of prednisolone was started orally, which resulted in improvement of most of sarcoid lesions. However, ocular lesion relapsed after the dosage of prednisolone was decreased to 10mg a day.
日本サルコイドーシス/肉芽腫性疾患学会の論文