eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2020-04-25 8 7 210 215 10.12691/ajmcr-8-7-13 AJMCR20208713 article Courtney Connelly 1 Abida Hasan 1 Zachary Chung 1 Erli Mingomataj 1 Vinodkumar Velayudhan 1 Isabel M. McFarlane Isabel.McFarlane@downstate.edu 1 Department of Internal Medicine, State University of New York- Downstate Health Science University, Brooklyn, NY, USA- 11203 Sarcoidosis is an idiopathic multisystem granulomatous disease that affects patients of all races and ethnic groups however predilection for women and African Americans is apparent. Extrapulmonary manifestations of sarcoidosis occur in up to 50% of cases. The most common sites of extrapulmonary involvement are the skin, eyes, liver, and reticuloendothelial system followed bt renal, cardiac, and neurological involvement. We present the case of a middle age man with exclusive extrapulmonary sarcoidosis affecting the renal, cardiac, hepatic, splenic and central nervous system. The patient sustained a second episode of venous thromboembolism which highlights a frequently seen complication of sarcoidosis. We discuss the proposed pathophysiology for the prothrombotic state seen in sarcoidosis and imaging modalities that can be utilized to assess extrapulmonary involvement in sarcoidosis. Lastly, sarcoidosis management is reviewed, highlighting that immunosuppressants and tumor necrosis factor inhibitors are being proposed to arrest disease progression and reduce glucocorticoid doses. http://pubs.sciepub.com/ajmcr/8/7/13/ajmcr-8-7-13.pdf sarcoidosis extrapulmonary manifestations cardiac sarcoidosis hepatic sarcoidosis neuro-sarcoidosis renal sarcoidosis venous thromboembolism arterial aneurysm stroke end stage renal disease