{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T17:17:11Z","timestamp":1790615831979,"version":"4.1.0"},"reference-count":20,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,9,20]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>A man in his 30s with longstanding ileal Crohn\u2019s disease was found to have pulmonary sarcoidosis during routine pre-biologic evaluation. Although he had no respiratory symptoms, lung function testing showed mildly reduced diffusion capacity. Radiological imaging demonstrated diffuse pulmonary nodules and mediastinal lymphadenopathy, and transbronchial biopsies confirmed non-necrotising granulomas consistent with sarcoidosis. In the setting of postoperative endoscopic Crohn\u2019s recurrence and pulmonary sarcoidosis with mildly reduced diffusion capacity, infliximab was selected to provide dual disease control. Crohn\u2019s disease improved endoscopically and histologically, while follow-up CT showed radiological improvement of the pulmonary sarcoidosis. This case highlights the diagnostic complexity of overlapping granulomatous diseases and the potential therapeutic advantage of tumour necrosis factor-alpha inhibition when treatment of both conditions is being considered.<\/jats:p>","DOI":"10.1136\/bcr-2026-273015","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:32:13Z","timestamp":1790613133000},"page":"e273015","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Crohn\u2019s disease unmasks pulmonary sarcoidosis on biologic screening: dual granulomatous pathology responsive to infliximab"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0162-2883","authenticated-orcid":false,"given":"Ezaam","family":"Fraz","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Chermside, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip Minh Tien","family":"Karpati","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Rubtsov","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Chermside, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Masel","sequence":"additional","affiliation":[{"name":"Department of Thoracic Medicine, The Prince Charles Hospital, Chermside, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh","family":"Kandpal","sequence":"additional","affiliation":[{"name":"Department of Radiology, The Prince Charles Hospital, Chermside, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Morgan","family":"Davidson","sequence":"additional","affiliation":[{"name":"Department of Pathology, The Prince Charles Hospital, Chermside, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myat Myat","family":"Khaing","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, The Prince Charles Hospital, Chermside, Queensland, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,28]]},"reference":[{"key":"2026092809301525000_19.9.e273015.1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(16)31711-1"},{"key":"2026092809301525000_19.9.e273015.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60680-7"},{"key":"2026092809301525000_19.9.e273015.3","doi-asserted-by":"publisher","DOI":"10.3109\/00365529509101635"},{"key":"2026092809301525000_19.9.e273015.4","doi-asserted-by":"crossref","unstructured":"Yi J , Wu S , He H . Causal association of inflammatory bowel disease with sarcoidosis and the mediating role of primary biliary cholangitis. Front Immunol 2024;15. doi:10.3389\/fimmu.2024.1448724","DOI":"10.3389\/fimmu.2024.1448724"},{"key":"2026092809301525000_19.9.e273015.5","doi-asserted-by":"crossref","first-page":"271","DOI":"10.1053\/j.gastro.2016.10.038","article-title":"American Gastroenterological Association Institute Guideline on the Management of Crohn\u2019s Disease After Surgical Resection","volume":"152","author":"Nguyen","year":"2017","journal-title":"Gastroenterology"},{"key":"2026092809301525000_19.9.e273015.6","doi-asserted-by":"crossref","unstructured":"Yanai H , Ellul P , Verstockt B , et al . ECCO Guidelines on the Prevention, Diagnosis, and Management of Infections in Inflammatory Bowel Disease. J Crohns Colitis 2026;20. doi:10.1093\/ecco-jcc\/jjag071","DOI":"10.1093\/ecco-jcc\/jjag071"},{"key":"2026092809301525000_19.9.e273015.7","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223335"},{"key":"2026092809301525000_19.9.e273015.8","doi-asserted-by":"publisher","DOI":"10.3238\/arztebl.2016.0565"},{"key":"2026092809301525000_19.9.e273015.9","doi-asserted-by":"crossref","unstructured":"Narula N , Iannuzzi MC . Sarcoidosis: Pitfalls and Challenging Mimickers. Front Med (Lausanne) 2020;7. doi:10.3389\/fmed.2020.594275","DOI":"10.3389\/fmed.2020.594275"},{"key":"2026092809301525000_19.9.e273015.10","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i1.133"},{"key":"2026092809301525000_19.9.e273015.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2008.02202.x"},{"key":"2026092809301525000_19.9.e273015.12","first-page":"419","article-title":"Gastric sarcoidosis and review of the literature","volume":"102","author":"Afshar","year":"2010","journal-title":"J Natl Med Assoc"},{"key":"2026092809301525000_19.9.e273015.13","doi-asserted-by":"crossref","unstructured":"Nicolosi S , Chernovsky M , Angoni D , et al . Gastrointestinal Manifestations of Sarcoidosis: A State-of-the-Art, Comprehensive Review of the Literature-Practical Clinical Insights and Many Unmet Needs on Diagnosis and Treatment. Pharmaceuticals (Basel) 2024;17. doi:10.3390\/ph17091106","DOI":"10.3390\/ph17091106"},{"key":"2026092809301525000_19.9.e273015.14","doi-asserted-by":"crossref","unstructured":"Rubin JN , George LA , Cross RK , et al . Sarcoidosis Mimicking Crohn Disease. Crohn\u2019s Colitis 360 2019;1. doi:10.1093\/crocol\/otz041","DOI":"10.1093\/crocol\/otz041"},{"key":"2026092809301525000_19.9.e273015.15","doi-asserted-by":"crossref","first-page":"499","DOI":"10.5694\/mja17.00610","article-title":"Sarcoidosis: a state of the art review from the Thoracic Society of Australia and New Zealand","volume":"208","author":"Ahmadzai","year":"2018","journal-title":"Med J Aust"},{"key":"2026092809301525000_19.9.e273015.16","doi-asserted-by":"publisher","DOI":"10.1111\/j.1346-8138.2010.00861.x"},{"key":"2026092809301525000_19.9.e273015.17","doi-asserted-by":"crossref","first-page":"74","DOI":"10.3393\/ac.2017.33.2.74","article-title":"Pulmonary Sarcoidosis That Developed During the Treatment of a Patient With Crohn Disease by Using Infliximab","volume":"33","author":"Kim","year":"2017","journal-title":"Ann Coloproctol"},{"key":"2026092809301525000_19.9.e273015.18","doi-asserted-by":"crossref","unstructured":"Mills K , Fatima S , Fas N . Crohn\u2019s Disease Diagnosed in a Man with Sarcoidosis: Coincidence or Correspondence? Case Rep Gastrointest Med 2022;2022. doi:10.1155\/2022\/5943468","DOI":"10.1155\/2022\/5943468"},{"key":"2026092809301525000_19.9.e273015.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2018.10.005"},{"key":"2026092809301525000_19.9.e273015.20","doi-asserted-by":"crossref","unstructured":"Baughman RP , Valeyre D , Korsten P , et al . ERS clinical practice guidelines on treatment of sarcoidosis. Eur Respir J 2021;58. doi:10.1183\/13993003.04079-2020","DOI":"10.1183\/13993003.04079-2020"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-273015","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T16:32:16Z","timestamp":1790613136000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-273015"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":20,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,28]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2026-273015"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-273015","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}