Multisystemic Sarcoidosis in the Primary Care Setting: A Case Report

基层医疗机构中的多系统结节病:病例报告

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Abstract

Sarcoidosis is a rare, multisystemic disease of unknown etiology, characterized by noncaseating granulomas in various organs. The disease often presents with nonspecific symptoms that complicate the diagnosis. We describe the case of a 31-year-old woman who presented to her family doctor with weight loss, cervical lymphadenopathy, parotid edema, and cutaneous lesions, initially raising suspicion of a lymphoproliferative disorder. A thoraco-abdominopelvic CT scan revealed extensive lymphadenopathy and multiorgan involvement, consistent with sarcoidosis. While awaiting outpatient evaluation by internal medicine, the patient developed arthralgias and was subsequently admitted for further investigation. She was ultimately diagnosed with sarcoidosis with multiorgan involvement, including the lymphatic, pulmonary, lacrimal, salivary, hepatic, splenic, and cutaneous systems. Retrospective analysis suggested that parotitis during pregnancy five years earlier was likely the initial manifestation of the disease. This case underscores the importance of early recognition and multidisciplinary management in sarcoidosis, particularly when the disease has widespread systemic involvement and nonspecific symptoms. Family physicians, often the first point of contact, play a crucial role in identifying early signs, ensuring appropriate referrals, and coordinating long-term follow-up.

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