Adjustable gastric banding in a patient with sarcoidosis

The use of silicone in patients with immune-compromising diseases is controversial because of fears that there may be inflammatory reactions against the material. We report the case of a patient who suffered from cutaneous sarcoidosis with bihilar lymphadenopathy and obesity (110 kg; BMI, 38 kg/m2) that was exaggerated by cortisone therapy. The patient underwent adjustable gastric banding because of aggravating comorbid hypertension and hyperlipidemia. Six months postoperatively, she had achieved an excess weight loss of 33%. During this period, she had a relapse of scar sarcoidosis of the right elbow and bilateral hilar lyphadenopathy. Although she was treated with a double dose of cortisone (8 mg daily), the scars from the laparoscopy as well as those in the gastric region adjacent to the band remained unaffected. We therefore believe that preexisting immune-compromising diseases are not an absolute contraindication against gastric banding, particularly since our patient experienced a notable improvement in her quality of life.