SARCOIDOSIS ASSOCIATED WITH RECURRENT PANCREATITIS

A 56-year-old previously healthy man had two episodes of unexplained p ancreatitis in the setting of constitutional symptoms, recurrent palsy of the right seventh cranial nerve, and bilateral parotitis. Chest ra diography revealed marked bilateral hilar lymphadenopathy, and sarcoid osis was diagnosed by bronchoscopy with transbronchial biopsy showing noncaseating granulomas. The pancreatitis and sarcoidosis responded to corticosteroid therapy but recurred after corticosteroid dosage was r educed. Retreatment with a higher dosage of corticosteroids led to res olution of pancreatitis; 3 months later, the patient remained well and without further recurrence of pancreatitis while taking the higher do se of corticosteroids. Clinically significant pancreatitis should be i ncluded as an unusual manifestation of sarcoidosis, and corticosteroid therapy should be considered in the management of pancreatitis associ ated with sarcoidosis.