{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:54:00Z","timestamp":1792598040856,"version":"4.5.0"},"reference-count":16,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":293,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Gastrointestinal Medicine"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Gastrointestinal involvement in sarcoidosis is rare, and clinically apparent disease occurs in fewer than 1% of patients. The stomach is the most frequently affected site, although presentations are usually indolent. Perforation is exceedingly rare, and to our knowledge, this is the first case of gastric perforation attributable to sarcoidosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case Presentation<\/jats:title>\n                    <jats:p>A 30\u2010year\u2010old woman presented with 4\u2009months of bilateral lower extremity paresthesia, pleuritic chest pain, progressive dyspnea, abdominal discomfort, and 50\u2009lb unintentional weight loss. Angiotensin\u2010converting enzyme and soluble interleukin\u20102 receptor were markedly elevated, and autoimmune serologies and extensive infectious workup were negative. Imaging revealed abdominal and pelvic lymphadenopathy, hepatosplenomegaly, and bilateral cavitary pulmonary opacities with mediastinal and hilar lymphadenopathy.<\/jats:p>\n                    <jats:p>During admission, she developed acute abdominal pain with pneumoperitoneum. Emergent laparotomy revealed a 6\u2010mm gastric perforation repaired with a Graham patch, with biopsies revealing lymphohistiocytic aggregates and multinucleated giant cells containing asteroid bodies. Subsequent endobronchial ultrasound\u2013guided mediastinal node biopsy demonstrated granulomatous lymphadenitis, and a bronchoalveolar lavage showed a cD4\/CD8 ratio of 15:1, suggesting sarcoidosis. Glucocorticoids were deferred due to surgical repair initially, and hydroxychloroquine was started. Subsequent lung wedge resection confirmed non\u2010necrotizing granulomas. Mycophenolate mofetil was then added and replaced by methotrexate with clinical improvement and resolution of symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Gastric perforation can be a severe complication in sarcoidosis, particularly in patients with multisystemic symptoms that are not otherwise explained. Multidisciplinary involvement is needed to appropriately treat these patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/crgm\/7100284","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:12:16Z","timestamp":1792595536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Gastric Perforation as a Manifestation of Sarcoidosis: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"given":"Sanjana L.","family":"Thimmannagari","sequence":"first","affiliation":[{"name":"Department of Internal Medicine Rochester General Hospital  1425 Portland Ave Rochester 14621 New York USA  rochesterregional.org"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5495-7973","authenticated-orcid":false,"given":"John","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Rochester General Hospital  1425 Portland Ave Rochester 14621 New York USA  rochesterregional.org"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4754-9872","authenticated-orcid":false,"given":"Asim","family":"Khanfar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Rochester General Hospital  1425 Portland Ave Rochester 14621 New York USA  rochesterregional.org"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sungeun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Rochester Regional Health  1425 Portland Ave Rochester 14621 New York USA  rochesterregional.org"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2903-5429","authenticated-orcid":false,"given":"Anthony J.","family":"Ocon","sequence":"additional","affiliation":[{"name":"Division of Allergy Immunology and Rheumatology Rochester Regional Health  222 Alexander St Ste 300 Rochester 14607 New York USA  rochesterregional.org"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_2_9_1_2","doi-asserted-by":"publisher","DOI":"10.3390\/ph17091106"},{"key":"e_1_2_9_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9082363"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-017-2210-3"},{"key":"e_1_2_9_4_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000171"},{"key":"e_1_2_9_5_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.12198"},{"key":"e_1_2_9_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.8623"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.22088\/cjim.16.3.584"},{"key":"e_1_2_9_8_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.71557"},{"key":"e_1_2_9_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-012-2336-8"},{"key":"e_1_2_9_10_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.66.3.295"},{"key":"e_1_2_9_11_2","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.202002-0251ST"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2022.1570"},{"key":"e_1_2_9_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0000000000001943"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01536930"},{"key":"e_1_2_9_15_2","first-page":"686","article-title":"Gastrointestinal Sarcoidosis With Esophageal Involvement-A Rare Clinical Experience","volume":"6","author":"Yousef J.","year":"2018","journal-title":"Scholars Journal of Medical Case Reports"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejim.2022.12.003"}],"container-title":["Case Reports in Gastrointestinal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crgm\/7100284","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1155\/crgm\/7100284","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1155\/crgm\/7100284","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:12:18Z","timestamp":1792595538000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1155\/crgm\/7100284"}},"subtitle":[],"editor":[{"given":"Neetu","family":"Rawal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":16,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1155\/crgm\/7100284"],"URL":"https:\/\/doi.org\/10.1155\/crgm\/7100284","archive":["Portico"],"relation":{},"ISSN":["2090-6528","2090-6536"],"issn-type":[{"value":"2090-6528","type":"print"},{"value":"2090-6536","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-03-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-10-21","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"7100284"}}