Gastric sarcoid: unusual cause of upper gastrointestinal hemorrhage

An unusual presentation of sarcoidosis was noted in a patient who developed severe upper gastrointestinal hemorrhage. The bleeding was attributed to a sarcoid ulcer of the stomach. Serial gastroscopic studies demonstrated complete resolution of the ulcer within five months on conventional antacid therapy. The only residual lesions were gastric mucosal nodularities and moderate hyperemia with granulomas on biopsy. Sarcoidosis was diagnosed by positive Kveim test and abnormal diffusing lung capacity despite a normal chest roentgenogram.