A case report of multisystemic sarcoidosis with extracardiac shunt


  • Faris K. Shamsudeen Department of Medicine, Travancore Medical College, Kollam, Kerala, India




Sarcoidosis, Multisystemic, Extracardiac shunt, Masquerader


A 61-year-old female patient, presented with complaints of dry cough and gradually worsening dyspnea of 3 months duration, associated with significant weight loss of >14 kg. At presentation, patient was sick, hypoxemic, and tachypneic and system examination revealed fine basal crepitations on auscultation. CT chest showed random pulmonary nodules with bronchiectatic changes. In view of respiratory distress and elevated d-dimer, CT pulmonary angiogram was done and was normal. A contrast echocardiography study hinted towards a significant right to left extracardiac shunt. There was radiological evidence of chronic liver disease with portal hypertension and numerous poorly defined nodular opacities scattered in hepatic and splenic parenchyma in post contrast images. ANA profile was positive for ribosomal-p protein along with elevated serum ACE levels. An ultrasound guided liver biopsy was ultimately performed and histopathology revealed granulomatous lesion in liver compatible with sarcoidosis.


Teles C, Teles C, Moreira S. Rare manifestations of refractory extrapulmonary sarcoidosis. BMJ Case Rep. 2023;16:e254829.

Mitchell DN, Scadding JG, Heard BE, Hinson KF. Sarcoidosis: histopathological definition and clinical diagnosis. J Clin Pathol. 1977;30(5):395-408.

Santosa A, Wong CF, Koh LW. Multisystemic sarcoidosis important lessons learnt from one of the great imitators. BMJ Case Rep. 2019;12(3):e227929.

El-Rhaoussi FZ, Banani S, Bouamama S, Bennani N, Badre W, Banani II S, et al. Multisystemic sarcoidosis revealed by hepatosplenomegaly: A case report. Cureus. 2022;14(4):12-8.

Sekhri V, Sanal S, DeLorenzo LJ, Aronow W, Maguire GP. Cardiac sarcoidosis: a comprehensive review. Archives of Medical Science. 2011;7(4):546-54.

Jain R, Yadav D, Puranik N, Guleria R, Jin JO. Sarcoidosis: causes, diagnosis, clinical features, and treatments. J Clin Med. 2020;9(4):1081.




How to Cite

Shamsudeen, F. K. (2023). A case report of multisystemic sarcoidosis with extracardiac shunt . International Journal of Research in Medical Sciences, 12(1), 273–276. https://doi.org/10.18203/2320-6012.ijrms20234018



Case Reports