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Reminder of important clinical lesson
Multiple pulmonary micronodules in a patient with Crohn's disease
  1. S A Abbas1,
  2. Y I Syed1,
  3. A Dushianthan2,
  4. S Barry1
  1. 1Department of Respiratory Medicine, Llandough University Hospital, Penarth, UK
  2. 2Department of Respiratory Medicine, Royal Glamorgan Hospital, Wales, UK
  1. Correspondence to S A Abbas, ali.abbas{at}doctors.org.uk

Summary

Sarcoidosis is a terrific mimicker and can present in many different ways. The case of a middle-aged woman with Crohn's disease who attended the gastroenterology clinic for routine follow-up is presented. She had dry cough and breathlessness for a few weeks. A chest x-ray showed scattered multiple bilateral pulmonary micronodules. This finding on her chest x-ray posed a diagnostic challenge, especially in view of the fact that she was previously treated with immunosuppressants to control her Crohn's disease. A diagnosis of sarcoidosis was established by various tests including lung biopsy, which showed non-caseating granulomas. Within a few weeks of beginning systemic steroid treatment, improvement was noticed in symptoms and lung function tests.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.

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