Chronic Dacryocystitis Revealing Systemic Sarcoidosis:
A Case Report

Dr Basma Ouidani *¹, F. Elbenkadri ², M. El Filali ³, Pr Hussein Ait lhaj ⁴, Pr Fouad Elasri ⁵

1. Military Hospital of Marrakech, Ophthalmology Department.

*Correspondence to: Dr Basma Ouidani, Military Hospital of Marrakech, Ophthalmology Department.

Copyright

© 2023 Dr Basma Ouidani. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original  work is properly cited.

Received: 22 August 2023

Published: 01 September 2023

Introduction

Dacryocystitis is an inflammation of the tear duct typically follows an obstruction of this duct with stagnation of tears in the lacrimal sac. Several etiologies can be at the origin of this abnormality.

We report, in our work, a clinical case of a dacryocystitis having revealed a systemic sarcoidosis. The aim of our work is to highlight the clinical particularities as well as the diagnostic approach of this entity which remains relatively rare.

Materiels et Methodes

We report the case of a 70-year-old patient who presented with chronic tearing of the left eye for 2 years with recurrent dacryocystitis in the same eye. On clinical examination, the patient presented with an inflammatory swelling of the inner angle of the left eye.

The general examination finds skin lesions of different ages, the youngest, which is located on the face, represents an erythematous plaque surmounted by nodules without any elective topography. The pulmonary auscultation revealed  diffuse whistling rales.

A skin biopsy was performed showing a granulomatous lesion without caseous necrosis.

A thinly cut chest CT scan was done showing a ground glass appearance.

Discussion

Sarcoidosis is a systemic granulomatosis of the young population;  characterized by a very vast clinical polymorphism due to the various plausible localizations with the Mediastinum-pulmonary on the top of the list.

Sarcoidosis of lacrimal sac is a very uncommon disease. When the patient has symptoms of lacrimal sac diseases, it is necessary to take into account the histological evaluation, to demonstrate the involvement of the lacrimal sac by this pathology. In patients with sarcoidosis history, the treatment is surgical and it is suggested to do an external dacryocystorhinostomy, in order to take a biopsy, to get a diagnosis and to establish the incidence of this pathology.

Conclusion

Sarcoidosis of lacrimal sac is very rare, the aim of this case is to highlight the particularities of its diagnostic approach.   

References

1. Nasolacrimal Duct Obstruction: An Unusual Presentation of Sarcoidosis. https://pubmed.ncbi.nlm.nih.gov/32865461/

2. Dacryocystitis and Rhinosinusitis Secondary to Sarcoidosis. https://pubmed.ncbi.nlm.nih.gov/30444768/
3. Sarcoidosis of the lacrimal sac. https://pubmed.ncbi.nlm.nih.gov/6266374/