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KOHLI RITESH, SIVA CHOKKALINGAM. Diplopia, Proptosis, and Joint Pain: Possibility of Osseous and Orbital Sarcoidosis. J Rheumatol 2018; 45:141-142. [DOI: 10.3899/jrheum.170439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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52
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Chauvet E, Blanche B, Aptel S, Costa K, Pallure V. Sarcoïdose osseuse axiale : étude 3 observations. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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53
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Osteolytic Sarcoidosis of the Orbital Roof Masquerading as a Malignant Orbital Lesion. Ophthalmic Plast Reconstr Surg 2017; 33:S94-S96. [PMID: 26226236 DOI: 10.1097/iop.0000000000000536] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A 51-year-old man without a significant past medical history presented with 4 weeks of progressive swelling and drooping of his left upper eyelid. A CT of the left orbit revealed an osteolytic mass lesion in the area of the lacrimal gland. A left orbitotomy with excisional biopsy was performed. The excised tissue was sent for infectious workup and histopathological examination, which revealed osteolytic sarcoidosis. The patient was treated with systemic and local injection corticosteroids, and followed over 10 months without evidence of recurrence. Systemic workup with CT of his chest, abdomen, and pelvis revealed no further evidence of sarcoidosis. To the best of the authors knowledge, this is the first report of an otherwise healthy patient presenting with isolated osteolytic sarcoidosis of the orbit and a negative systemic workup.
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Madureira P, Pimenta S, Cardoso H, Guimarães Cunha R, Costa L. Sarcoidosis: An unusual presentation. REUMATOLOGIA CLINICA 2017; 13:227-229. [PMID: 27068192 DOI: 10.1016/j.reuma.2016.03.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 03/01/2016] [Indexed: 06/05/2023]
Abstract
A 35-year-old man presented with a 3-year history of arthralgia and purple coloration of the skin of his fingers and feet. Hand and foot radiography showed cystic bone lesions on phalanges suggestive of sarcoidosis. Lab tests revealed increased liver enzymes. Liver MRI evidenced an enlarged liver and retroperitoneal lymphadenopathy. Histological analysis of the finger skin, lymph nodes and liver demonstrated the presence of granulomas, confirming the diagnosis of sarcoidosis. The patient started prednisolone with rapid improvement of the symptoms. Skin lesions are divided into two groups: specific for sarcoidosis (with granulomas, lupus pernio-like) and nonspecific (without granulomas, erythema nodosum-like). Specific cutaneous lesions usually cause no other symptoms beyond cosmetic changes. Lupus pernio stands out for having distinctive features but, to the best of our knowledge, the simultaneous involvement of both hands and feet has never been reported.
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Affiliation(s)
- Pedro Madureira
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal; Rheumatology Department, Faculdade de Medicina da Universidade do Porto, Porto, Portugal.
| | - Sofia Pimenta
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal; Rheumatology Department, Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - Hélder Cardoso
- Gastrenterology Department, Centro Hospitalar de São João, Porto, Portugal
| | | | - Lúcia Costa
- Rheumatology Department, Centro Hospitalar de São João, Porto, Portugal
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Zhou Y, Lower EE, Li H, Farhey Y, Baughman RP. Clinical characteristics of patients with bone sarcoidosis. Semin Arthritis Rheum 2017; 47:143-148. [PMID: 28274482 DOI: 10.1016/j.semarthrit.2017.02.004] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/26/2017] [Accepted: 02/04/2017] [Indexed: 01/13/2023]
Abstract
OBJECTIVE To assess the clinical features, diagnosis, and treatment of bone sarcoidosis in the United States. METHODS Patients with bone sarcoidosis were identified and matched to sarcoidosis patients based on race, gender, and age. Detailed characteristics were obtained by medical record review. RESULTS A total of 64 patients with bone sarcoidosis were enrolled in this study. The female:male ratio was 1.46:1 and the white:black ratio was 3:1. Thirty-eight (59.4%) of 64 patients had bone symptoms. Compared to matched cases, bone sarcoidosis patients have more multi-organ involvement and higher incidence with liver, spleen, and extrathoracic lymph node involvement than controls (P < 0.05). Spine was the most commonly affected bone in 44 (68.8%) of patients, followed by pelvis (35.9%), and hands (15.6%). MRI and PET/CT scan was the common imaging technology, which performed in 36 patients and 32 patients, respectively, and with 97.2% and 93.8% positive bone uptake. Laboratory test indicated anemia was more common in bone sarcoidosis group than controls (P = 0.044). Infliximab was more commonly used in bone sarcoidosis patients than controls (P = 0.009). CONCLUSION Bone sarcoidosis was associated with multi-organs affection, and high frequency of liver, spleen, or extrathoracic lymph node involvement. Infliximab should be considered in those patients with aggressive and refractory bone sarcoidosis.
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Affiliation(s)
- Ying Zhou
- Department of Internal Medicine, University of Cincinnati Medical Center, 1001 Holmes, Eden Ave, Cincinnati, OH 45267; Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Elyse E Lower
- Department of Internal Medicine, University of Cincinnati Medical Center, 1001 Holmes, Eden Ave, Cincinnati, OH 45267
| | - Huiping Li
- Department of Respiratory Medicine, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yolanda Farhey
- Department of Internal Medicine, University of Cincinnati Medical Center, 1001 Holmes, Eden Ave, Cincinnati, OH 45267
| | - Robert P Baughman
- Department of Internal Medicine, University of Cincinnati Medical Center, 1001 Holmes, Eden Ave, Cincinnati, OH 45267.
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Nureki SI, Miyazaki E, Yamasue M, Takenaka R, Ando M, Kadota JI. Intrascrotal and osseous sarcoidosis mimicking intrascrotal organ cancer and bony metastasis. SARCOIDOSIS VASCULITIS AND DIFFUSE LUNG DISEASES 2017; 34:373-379. [PMID: 32476871 DOI: 10.36141/svdld.v34i4.5523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 06/29/2017] [Indexed: 11/02/2022]
Abstract
We report a case of sarcoidosis with concomitant epididymis, testes, and phalanxes involvement mimicking intrascrotal organ cancer and metastatic bony disease. A 23-year-old man developed blurred vision and hyperemia of the left eye, and was diagnosed as having left iritis. A chest computed tomography scan detected bilateral hilar lymphadenopathy and lung nodular shadows. A transbronchial lung biopsy revealed a non-caseating granuloma and he was diagnosed with sarcoidosis. One year after the onset of his eye symptoms, he noticed enlargement of his right scrotum. Magnetic resonance imaging detected lesions of the right epididymis, bilateral testes, and bilateral phalanxes. A technetium-99m scintigram revealed a high accumulation in the bilateral bones of extremities. These radiological findings mimicked intrascrotal organ cancer and metastatic bony disease. Pathologic evaluation following the right epididymectomy revealed non-caseating granulomas compatible with sarcoidosis. Three and half years after the appearance of intrascrotal and bony lesions, they improved spontaneously. (Sarcoidosis Vasc Diffuse Lung Dis 2017; 34: 373-376).
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Affiliation(s)
| | - Eishi Miyazaki
- Center for Community Medicine, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama-machi, Yufu, Oita 879-5593, Japan
| | - Mari Yamasue
- Department of Respiratory Medicine and Infectious Diseases and
| | | | - Masaru Ando
- Department of Respiratory Medicine and Infectious Diseases and
| | - Jun-Ichi Kadota
- Department of Respiratory Medicine and Infectious Diseases and
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57
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Sweeney A, Hammer R, Evenski A, Crim J. Fulminant musculoskeletal and neurologic sarcoidosis: case report and literature update. Skeletal Radiol 2016; 45:1571-6. [PMID: 27596753 DOI: 10.1007/s00256-016-2463-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 07/23/2016] [Accepted: 08/12/2016] [Indexed: 02/02/2023]
Abstract
We report a case of fulminant sarcoidosis in a 28-year-old man presenting with skin nodules, multifocal small and large joint arthralgias, and blurred vision. Characteristic bone, soft tissue, articular, and CNS findings were evident on multimodality imaging. Bony abnormalities included near-complete destruction of a distal phalanx, "lace-like" lucent lesions, erosive arthritis, lytic lesions with and without sclerotic margins, and bone marrow replacement visible only on MRI. The extent of bony disease at time of presentation was unusual. We review the widely varying reported prevalence of imaging findings of bony sarcoidosis in the literature, and discuss reasons for this variability. We found that musculoskeletal findings at US and MRI were less specific than radiographic and CT findings, but were useful in quantifying extent of disease.
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Affiliation(s)
| | | | | | - Julia Crim
- University of Missouri at Columbia, Columbia, MO, USA.
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Vu K, Atkinson J, Ranganathan P. Bone Lesions, Lymphadenopathy, and Hepatic Granulomas in a Patient With Psoriasis. Arthritis Care Res (Hoboken) 2016; 68:394-9. [PMID: 25941093 DOI: 10.1002/acr.22607] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 03/30/2015] [Accepted: 04/28/2015] [Indexed: 12/26/2022]
Affiliation(s)
- Khoan Vu
- Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - John Atkinson
- Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Prabha Ranganathan
- Washington University in St. Louis School of Medicine, St. Louis, Missouri
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Albers BK, Sluzevich JC, Garner HW. Sarcoidosis: radiographic manifestations in the nails and distal phalanges. Skeletal Radiol 2016; 45:717-21. [PMID: 26768259 DOI: 10.1007/s00256-015-2326-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Revised: 12/09/2015] [Accepted: 12/28/2015] [Indexed: 02/02/2023]
Abstract
Sarcoidosis is a granulomatous disease which can affect multiple organ systems. Clinical and radiologic manifestations depend on the organ system involved and the chronicity of disease. Nail involvement in sarcoidosis is rare, but is clinically relevant as it indicates chronic systemic disease. Nail abnormalities can be identified radiographically, and when seen in patients with known or suspected sarcoidosis, should prompt careful evaluation of the underlying bone for osseous involvement. We describe a case of sarcoidosis with radiographic findings in the nails and distal phalangeal tufts, which were indicative of nail and osseous sarcoid involvement and strongly supported the presence of chronic systemic disease. Although the nail findings resolved clinically and on radiographs after treatment, the osseous findings showed only minimal improvement. To our knowledge, the radiographic findings of nail sarcoidosis have not been previously addressed in the literature.
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Affiliation(s)
- Brittany K Albers
- Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Jason C Sluzevich
- Department of Dermatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA
| | - Hillary W Garner
- Department of Radiology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
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Yee AM. Sarcoidosis: Rheumatology perspective. Best Pract Res Clin Rheumatol 2016; 30:334-356. [DOI: 10.1016/j.berh.2016.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 07/12/2016] [Indexed: 02/07/2023]
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Wiesli MG, Hostettler KE, Tamm M, Jaquiéry C. Osteolysis of unknown origin: a case report. BMC Oral Health 2015; 15:168. [PMID: 26714733 PMCID: PMC4696298 DOI: 10.1186/s12903-015-0158-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 12/18/2015] [Indexed: 11/20/2022] Open
Abstract
Background Sarcoidosis is a granulomatous disease that may affect any organ of the body. The most frequent loci of manifestation are the lungs. However, there are individual cases where bones are affected. The literature describes cases in which swelling or fistula were the first findings of a bone lesion. This is the first case reporting an osteolysis in both angles of the mandibles which led to the diagnosis of sarcoidosis with multi-organ involvement. Case presentation The authors present a 74 years old European female patient without previous diagnosis of sarcoidosis who presented with pain in the area of the jaw angles. There were no further clinical symptoms. Bone biopsy following radiological investigation demonstrated non-caseating granulomas consistent with sarcoidosis of the bone. Further evaluation confirmed multi-organ disease with involvement of lungs, intrathoracic lymph nodes, and the central nervous system. Conclusion This case report shows that diagnosis of a severe disease can be missed if systematic clinical signs are not given. Furthermore, an accurate anamnesis and examination is required to receive an early diagnosis which often needs an interdisciplinary approach.
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Affiliation(s)
- Matthias Guido Wiesli
- Clinic for Craniomaxillofacial and Oral Surgery, University Hospital Basel, Spitalstrasse 21 4031, Basel, Switzerland.
| | - Katrin E Hostettler
- Clinics of Respiratory Medicine, University Hospital Basel, Petersgraben 4 4031, Basel, Switzerland.
| | - Michael Tamm
- Clinics of Respiratory Medicine, University Hospital Basel, Petersgraben 4 4031, Basel, Switzerland.
| | - Claude Jaquiéry
- Clinic for Craniomaxillofacial and Oral Surgery, University Hospital Basel, Spitalstrasse 21 4031, Basel, Switzerland.
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Acar T, Savas R, Kocacelebi K, Ucan ES. Corticosteroid Responsive Sarcoidosis with Multisystemic Involvement Years after Initial Diagnosis: A Lymphoma Mimicker on 18-FDG PET/CT. J Clin Imaging Sci 2015; 5:40. [PMID: 26312138 PMCID: PMC4541162 DOI: 10.4103/2156-7514.161850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 07/17/2015] [Indexed: 11/16/2022] Open
Abstract
Sarcoidosis is a chronic multisystemic inflammatory disease characterized by noncaseating epithelioid cell granulomas. 18-Fluorodeoxyglucose positron-emission tomography/computer tomography (FDG-PET/CT) is increasingly used in routine clinical practice to assess active sarcoidosis because it can detect active inflammatory granulomatous disease. However, active sarcoidosis lesions are observed to be hypermetabolic on FDG-PET/CT much like malignancies, which may lead to misinterpretation on imaging. In this case report, we present a rare case of sarcoidosis with multisystem involvement including lung, lymph nodes, bone, pleura, and soft tissue that mimicked lymphoma on FDG-PET/CT and responded to corticosteroid treatment.
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Affiliation(s)
- Turker Acar
- Department of Radiology, Abant İzzet Baysal University, Training and Research Hospital, Bolu, Turkey
| | - Recep Savas
- Department of Radiology, School of Medicine, Ege University, Izmir, Turkey
| | - Kenan Kocacelebi
- Department of Nuclear Medicine, Ege Rad Diagnostic Imaging Center, Izmir, Turkey
| | - Eyup Sabri Ucan
- Department of Chest Diseases, School of Medicine, Dokuz Eylül University, Izmir, Turkey
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63
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Yachoui R, Parker BJ, Nguyen TT. Bone and bone marrow involvement in sarcoidosis. Rheumatol Int 2015; 35:1917-24. [DOI: 10.1007/s00296-015-3341-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 08/01/2015] [Indexed: 11/30/2022]
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64
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Al-Bari MAA. Chloroquine analogues in drug discovery: new directions of uses, mechanisms of actions and toxic manifestations from malaria to multifarious diseases. J Antimicrob Chemother 2015; 70:1608-21. [PMID: 25693996 PMCID: PMC7537707 DOI: 10.1093/jac/dkv018] [Citation(s) in RCA: 287] [Impact Index Per Article: 31.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Antimalarial drugs (e.g. chloroquine and its close structural analogues) were developed primarily to treat malaria; however, they are beneficial for many dermatological, immunological, rheumatological and severe infectious diseases, for which they are used mostly today. Chloroquine and hydroxychloroquine, two of the most fascinating drugs developed in the last 50 years, are increasingly recognized for their effectiveness in myriad non-malarial diseases. In advanced research, chloroquine and hydroxychloroquine have been shown to have various immunomodulatory and immunosuppressive effects, and currently have established roles in the management of rheumatic diseases, lupus erythematosus (different forms) and skin diseases, and in the treatment of different forms of cancer. Recently, chloroquine analogues have also been found to have metabolic, cardiovascular, antithrombotic and antineoplastic effects. This review is concerned with the lysosomotropic, anti-inflammatory and immunomodulatory mechanisms of chloroquine, hydroxychloroquine, quinacrine and related analogues, and the current evidence for both their beneficial effects and potential adverse manifestations in various diseases.
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