• T Frapard, C Le Pendu, V Meignin, A Coffin, E Mariotte, L Zafrani, and E Ghrenassia.
• Service de médecine intensive et réanimation, hôpital Saint-Louis, Pr Azoulay, AP-HP, 1, avenue Claude-Vellefaux, 75010 Paris, France. Electronic address: thomas.frapard@aphp.fr.
• Rev Med Interne. 2019 Sep 1; 40 (9): 609-612.

BackgroundHistological diagnosis of systemic granulomatosis may be difficult. The question of the best histological target remains unanswered.CaseWe report here the observation of a patient admitted in intensive care unit for severe hypercalcemia in the context of polylymphadenopathy and constitutional symptoms. Assessment of this hypercalcemia was suggestive of systemic granulomatosis. The CT (computed tomodensitometry) revealed lymphadenopathies of the mediastinum and the hepatic hilus, hepatomegaly and heterogeneous splenomegaly. At this stage, our main hypotheses were: lymphoid hematopathy, sarcoidosis, tuberculosis. An echo-guided biopsy of the spleen allowed the histological diagnosis of systemic granulomatosis suggestive of sarcoidosis, without significant complication in the course.ConclusionThis observation illustrates the efficiency and safety of spleen biopsy for the histological diagnosis of systemic granulomatosis.Copyright © 2019 Société Nationale Française de Médecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.

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