Beyond the lungs: Multisystemic sarcoidosis as a rare infertility cause

Sarcoidosis is a systemic granulomatous disease of unknown origin, characterized by non- necrotizing granulomas that can affect various organs, notably the lungs, lymph nodes, skin, and eyes. Diagnosis relies on clinical presentation, histological evidence, and exclusion of other granulomatous diseases. This case report discusses a 49-year-old Moroccan man who was initially treated for pulmonary tuberculosis based on clinical, radiological, and histological findings. Despite treatment, his condition worsened, prompting further investigation. Symptoms included dyspnea, xerostomia, xerophthalmia, polyarthralgia, paresthesia, and recurrent oral ulcers, along with significant weight loss and infertility. Clinical examination revealed a range of symptoms, including neurological deficits and elevated angiotensin-converting enzyme (ACE) levels. Imaging studies showed diffuse interstitial lung involvement. A bronchial biopsy was suggestive of sarcoidosis, supporting the diagnosis. The patient also exhibited ocular, neurological, and urogenital manifestations, including azoospermia. This case highlights the complexity of diagnosing sarcoidosis, particularly when symptoms mimic other conditions, and underscores the importance of considering sarcoidosis in differential diagnoses to avoid misdiagnosis and ensure timely treatment.