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Ben Hassine I, Rein C, Comarmond C, Glanowski C, Saidenberg-Kermanac’h N, Meunier B, Schleinitz N, Chanson N, Sacré K, Scherlinger M, Richez C, Hirschi S, Groh M, Devilliers H, Bielefeld P, Saadoun D, Chapelon-Abric C, Arnaud L, Cacoub P. Osseous sarcoidosis: A multicenter retrospective case-control study of 48 patients. Joint Bone Spine 2019; 86:789-793. [DOI: 10.1016/j.jbspin.2019.07.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 07/16/2019] [Indexed: 10/26/2022]
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Sahli H, Bachali A, Amri R, Bouzaidi K, Tekaya R. Traitement par méthotrexate lors d’une sarcoïdose osseuse digitale multifocale : à propos d’un cas. Therapie 2018; 73:547-549. [PMID: 29980295 DOI: 10.1016/j.therap.2017.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Revised: 04/08/2017] [Accepted: 05/12/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Hana Sahli
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de médecine interne, hôpital universitaire Maamouri, 8000 Nabeul, Tunisie
| | - Asma Bachali
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Laboratoire de biologie médicale, hôpital universitaire Maamouri, 8000 Nabeul, Tunisie.
| | - Raja Amri
- Service de médecine interne, hôpital universitaire Maamouri, 8000 Nabeul, Tunisie
| | - Khaled Bouzaidi
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de radiologie, hôpital universitaire Maamouri, 8000 Nabeul, Tunisie
| | - Rawdha Tekaya
- Faculté de médecine de Tunis, université de Tunis El Manar, 1007 Tunis, Tunisie; Service de rhumatologie, hôpital Charles-Nicolle, 1006 Tunis, Tunisie
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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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Ahmanna-Chakir F, Becce F, Aubry-Rozier B. Osseous Sarcoidosis Revealed by a Pathologic Fracture and Successfully Treated With Methotrexate and Prednisone. Arthritis Rheumatol 2016; 68:472. [PMID: 26479163 DOI: 10.1002/art.39454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/22/2015] [Indexed: 11/07/2022]
Affiliation(s)
| | - Fabio Becce
- Lausanne University Hospital, Lausanne, Switzerland
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Bours S, de Vries F, van den Bergh JPW, Lalmohamed A, van Staa TP, Leufkens HGM, Geusens PPP, Drent M, Harvey NC. Risk of vertebral and non-vertebral fractures in patients with sarcoidosis: a population-based cohort. Osteoporos Int 2016; 27:1603-1610. [PMID: 26630976 PMCID: PMC4791462 DOI: 10.1007/s00198-015-3426-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 11/13/2015] [Indexed: 11/12/2022]
Abstract
UNLABELLED In this retrospective cohort study using the Clinical Practice Research Datalink (CPRD), patients with sarcoidosis have an increased risk of clinical vertebral fractures and when on recent treatment with oral glucocorticoids, also an increased risk of any fractures and osteoporotic fractures. INTRODUCTION Sarcoidosis is a chronic inflammatory disease, in which fragility fractures have been reported despite normal BMD. The aim of this study was to assess whether patients with sarcoidosis have an increased risk of clinical fractures compared to the general population. METHODS A retrospective cohort study was conducted using the CPRD. All patients with a CPRD code for sarcoidosis between January 1987 and September 2012 were included. Cox proportional hazards models were used to derive adjusted relative risks (RRs) of fractures in all sarcoidosis patients compared to matched controls, and within the sarcoidosis group according to use and dose of systemic glucocorticoids. RESULTS Five thousand seven hundred twenty-two sarcoidosis patients (mean age 48.0 years, 51 % females, mean follow-up 6.7 years) were identified. Compared to 28,704 matched controls, the risk of any fracture was not different in patients with sarcoidosis. However, the risk of clinical vertebral fractures was significantly increased (adj RR 1.77; 95 % CI 1.06-2.96) and the risk of non-vertebral fractures was decreased although marginally significant (adj RR 0.87; 95 % CI 0.77-0.99). Compared to sarcoidosis patients not taking glucocorticoids, recent use of systemic glucocorticoids was associated with an increased risk of any fracture (adj RR 1.50; 95 % CI 1.20-1.89) and of an osteoporotic fracture (adj RR 1.47; 95 % CI 1.07-2.02). CONCLUSIONS Patients with sarcoidosis have an increased risk of clinical vertebral fractures, and when using glucocorticoid therapy, an increased risk of any fractures and osteoporotic fractures. In contrast, the risk of non-vertebral fractures maybe decreased. Further investigation is needed to understand the underlying mechanisms of these contrasting effects on fracture risk.
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Affiliation(s)
- S Bours
- Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - F de Vries
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, The Netherlands.
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK.
- Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre, Maastricht, The Netherlands.
- CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands.
| | - J P W van den Bergh
- Department of Internal Medicine, Viecuri MC Venlo, Venlo, The Netherlands
- NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands
- Biomedical Research Institute, Hasselt University, Hasselt, Belgium
| | - A Lalmohamed
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, The Netherlands
- Department of Clinical Pharmacy, University Medical Center Utrecht, Utrecht, The Netherlands
| | - T P van Staa
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, The Netherlands
- Farr Institute, University of Manchester, Manchester, UK
| | - H G M Leufkens
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht, The Netherlands
| | - P P P Geusens
- Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Biomedical Research Institute, Hasselt University, Hasselt, Belgium
| | - M Drent
- ILD Center of Excellence, St. Antonius Hospital, Nieuwegein, The Netherlands
- Department of Pharmacology and Toxicology, FHML, University Maastricht, Maastricht, The Netherlands
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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Affiliation(s)
- Zain S Gowani
- Vanderbilt Orthopaedic Oncology, 1215 21st Avenue South, Suite 4200, Medical Center East, South Tower, Nashville, TN 37232
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Sada M, Saraya T, Ishii H, Goto H. Sudden multiple fractures in a patient with sarcoidosis in multiple organs. BMJ Case Rep 2014; 2014:bcr-2013-201408. [PMID: 24711466 DOI: 10.1136/bcr-2013-201408] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 30-year-old man who incidentally fractured his right olecranon and other multiple phalanges was admitted to our hospital. He had a 2-year history of uveitis and bilateral hilar lymphadenopathy (BHL), and pulmonary sarcoidosis was diagnosed from transbronchial lung biopsy. Right elbow arthrodesis was performed, and biopsied specimens showed non-caseating epithelioid cell granuloma, suggesting osseous sarcoidosis. He was discharged uneventfully without further treatment, but BHL had progressed with the appearance of lung parenchymal lesions 3 months later. At that time, involvement of other organs was also noted on Gallium-67 scintigraphy, showing accumulations in BHL, axillary and inguinal lymph nodes, enlarged liver and spleen and subcutaneous areas. After initiation of steroid therapy, multiple organ involvement improved, and no further bone involvement has been recognised to date. Osseous sarcoidosis complicated by bone fracture is an extremely rare presentation, but should be considered in patients with sarcoidosis, especially when multiple organs are involved.
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Affiliation(s)
- Mitsuru Sada
- Department of Respiratory Medicine, Kyorin University School of Medicine, Mitaka, Japan
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Sakellariou GT, Anastasilakis AD, Karanikolas D, Vounotrypidis P, Berberidis C. Central skeletal sarcoidosis: a case report with sustained remission only on methotrexate, and a literature review on the imaging approach, treatment, and assessment of disease activity. Mod Rheumatol 2012; 23:175-81. [PMID: 22437922 DOI: 10.1007/s10165-012-0631-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2011] [Accepted: 03/05/2012] [Indexed: 11/24/2022]
Abstract
We report a case of multifocal involvement of the central skeleton in a patient with long-term stage I pulmonary sarcoidosis who experienced sustained clinical remission of musculoskeletal symptoms while on methotrexate (MTX) alone. Concomitant normalization of laboratory tests [inflammatory markers and angiotensin-converting enzyme (ACE) levels] was observed, and improvements were seen in follow-up magnetic resonance imaging (MRI) of the lumbar spine and bone scintigraphy. To date, there are no specific tools for the assessment of skeletal disease activity in sarcoidosis. Our case suggests that inflammatory markers and ACE levels, when initially elevated, bone scintigraphy, and-in the case of vertebral involvement-MRI could serve as such tools. A literature review on the imaging approach, treatment, and disease activity monitoring of skeletal sarcoidosis is also provided.
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Affiliation(s)
- Grigorios T Sakellariou
- Department of Rheumatology, 424 General Military Hospital, Ring Road N.Efkarpias, 564 03, Thessaloniki, Greece.
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