DEATH DUE TO MULTIPLE ORGAN SARCOIDOSIS DISGUISED BY SEVERE ENDOVASCULAR DISEASE

Introduction Sarcoidosis is a granulomatous disease of unknown etiology, usually with multiple organ involvement. Pulmonary manifestation is the most common, clinically manifested by cough, dyspnea and respiratory failure. In about 30% of cases, the course is chronic. The chronic form causes progressive and life-threatening limitation of lung function. Fatal outcome due to the disease is observed in about 1-5% of patients. Materials and Methods The present study presents a case of a 62-year-old woman with undiagnosed sarcoidosis during her lifetime. She has been admitted for hospital treatment due to persistent fever and trophic changes in the limbs, diagnosed as chronic arterial and venous insufficiency 5th degree. After the death in the medical institution, a forensic autopsy of the body has been performed and a histopathological examination of intra-organ parts was performed. Results After analysis of the morphological finding during the autopsy, as well as the results of a subsequent histological examination, the cause of death has been established as acute respiratory failure, which has occurred due to advanced pulmonary and multiorgan chronic productive granulomatous process (sarcoidosis). Discussion The presented case study focuses on the possibility of chronic progressive multiorgan involvement due to sarcoidosis not to be diagnosed in time due to masking by severe endovascular disease. Conclusion The many unknown factors associated with the prevalence of sarcoidosis in the population, together with the ever-increasing number of reports of mortality due to complications of this disease, stress on the need to develop a program for targeted clinical recognition and diagnosis. The diagnostic challenge is even greater when another disease masks the clinical course of sarcoidosis.