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Liu Z, Tang Z, Yuan J, Su K, Jian Y, Liu H. Deep lymph node enlargement and renal failure caused by hypercalcemia‑associated sarcoidosis: A case report. Exp Ther Med 2024; 27:235. [PMID: 38628656 PMCID: PMC11019652 DOI: 10.3892/etm.2024.12524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 12/14/2022] [Indexed: 04/19/2024] Open
Abstract
Sarcoidosis is a rare disease that severely affects the lungs and superficial lymph nodes. In addition, this disease can also affect the skin, eyes and kidneys to varying degrees. The present report described a 32-year-old male patient who was admitted to Renmin Hospital of Wuhan University (Wuhan, China) due to joint pain in the extremities. He was diagnosed with uncorrectable hypercalcemia. A lymph node biopsy revealed the hypercalcemia to be associated with sarcoidosis, with the patient also demonstrating renal failure and lymph node enlargement. Administration of glucocorticoids provided benefits in terms of both primary and recurrent sarcoidosis, which also improved and preserved renal function. After being prescribed with oral prednisone treatment, blood calcium levels returned to normal, which indicated markedly improving renal function. However, the discontinuation of glucocorticoids for 2 months resulted in increased serum calcium and creatinine levels, both of which returned to abnormal levels. Overall, the present case report suggests that clinicians should actively perform sarcoidosis treatment in clinical practice to overcome any unexpected results associated with organ damage.
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Affiliation(s)
- Zezhou Liu
- Department of Nephrology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Zhigang Tang
- Department of Pancreatic Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Jingping Yuan
- Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Ke Su
- Department of Nephrology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Yonghong Jian
- Department of Nephrology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
| | - Hongyan Liu
- Department of Nephrology, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, P.R. China
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Qi R, Yang W, Zhu S, Mao J, Yang B, Xu A, Fu Q. Transcatheter arterial chemoembolization of apatinib and camrelizumab (SHR1210) against liver metastasis from hepatic neuroendocrine tumor: a case report. Front Oncol 2024; 14:1278340. [PMID: 38384807 PMCID: PMC10880017 DOI: 10.3389/fonc.2024.1278340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 01/23/2024] [Indexed: 02/23/2024] Open
Abstract
In this case report, we present the case of a 46-year-old woman with a hepatic neuroendocrine tumor (NET G2)-induced liver metastases. Initially, the left lateral lobectomy of the liver was performed. The post-operative pathological examination revealed NET G2, leading to the post-operative recovery with a general review. Further, the re-examination of liver magnetic resonance imaging (MRI) showed post-operative changes in the tumor of the left lateral lobe, with multiple liver masses and possible metastasis. Thus, the liver interventional therapy and apatinib-based targeted therapy based on the "camrelizumab + apatinib" regimen were performed, respectively. The 20-month follow-up indicated a slightly increased hepatic hilum and retroperitoneal lymph nodes, accompanied by hand-foot syndrome. Eventually, the overall condition continued to relieve, indicating that the combined treatment could substantially improve the NET G2 conditions-associated liver metastasis.
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Affiliation(s)
- Ruobing Qi
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
- Second School of Clinical Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenhua Yang
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Sixian Zhu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Mao
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Bei Yang
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Anhui Xu
- Department of Radiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiang Fu
- Department of Oncology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Rhazari M, Ramdani A, Gartini S, Bouali S, Aharmim M, Thouil A, Kouismi H, Bourkadi JE. Mammary sarcoidosis: A rare case report. Ann Med Surg (Lond) 2022; 78:103892. [PMID: 35734652 PMCID: PMC9207054 DOI: 10.1016/j.amsu.2022.103892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 05/23/2022] [Accepted: 05/29/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction Sarcoidosis is an inflammatory, systemic, idiopathic disease characterized by multisystem involvement, of which mediastinal and pulmonary involvement is the most frequent. Mammary sarcoidosis is exceptional. Case presentation We report the case of a 50-year-old, diagnosed with mediastinal and mammary sarcoidosis. Therapeutic abstention with clinical and radiological surveillance was recommended. The evolution was marked by a clear improvement (clinical and radiological). Discussion Mammary sarcoidosis is a rare anatomical and clinical entity which poses a problem of differential diagnosis with other granulomatous diseases and especially with breast carcinoma. The coexistence of systemic manifestations should lead to the discussion of sarcoidosis. Conclusion Mammary sarcoidosis involvement is rare and is manifested by a mass with a smooth or spiculated border, requiring the exclusion of malignancy. Mammary sarcoidosis is a rare clinical entity. The final diagnosis is based on a combination of clinical, biological, radiological, and pathological findings. The main differential diagnosis of mammary sarcoidosis is tuberculosis and breast cancer. Corticosteroid therapy is the reference treatment for breast sarcoidosis.
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Diallo BD, Diot B, Flament T, Plantier L, Diot P, Sow OY, Marchand-Adam S. [The pentoxifylline, a corticosteroid sparing in the treatment of sarcoidosis: A case report]. REVUE DE PNEUMOLOGIE CLINIQUE 2018; 74:48-51. [PMID: 29122398 DOI: 10.1016/j.pneumo.2017.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 08/08/2017] [Indexed: 06/07/2023]
Abstract
INTRODUCTION The pentoxifylline seems to have some effects on immune cells by inhibiting tumor necrosis factor alpha (TNFα). Its role as a sparing corticosteroids in the treatment of sarcoidosis remains to be defined. CLINICAL CASE We present the case of a patient with sarcoidosis corticodependent despite the use of azathioprine. It was finally improved clinically, functionally and by a thoracic computed tomography with addition of pentoxifylline. CONCLUSION When the tolerance of the pentoxifylline is good and there is not a bleeding risk, the benefit-risk in the long term might be interesting in some patients with sarcoidosis corticodependent.
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Affiliation(s)
- B D Diallo
- Service de pneumologie et explorations fonctionnelles respiratoires, CHU de Tours, 37032 Tours, France; Inserm U-1100/EA-6305, centre d'études des pathologies respiratoires, faculté de médicine François-Rabelais, 37032 Tours, France; Service de pneumologie, hôpital Ignace-Deen, Conakry, Guinée
| | - B Diot
- Service de pneumologie et explorations fonctionnelles respiratoires, CHU de Tours, 37032 Tours, France
| | - T Flament
- Service de pneumologie et explorations fonctionnelles respiratoires, CHU de Tours, 37032 Tours, France
| | - L Plantier
- Service de pneumologie et explorations fonctionnelles respiratoires, CHU de Tours, 37032 Tours, France; Inserm U-1100/EA-6305, centre d'études des pathologies respiratoires, faculté de médicine François-Rabelais, 37032 Tours, France
| | - P Diot
- Service de pneumologie et explorations fonctionnelles respiratoires, CHU de Tours, 37032 Tours, France; Inserm U-1100/EA-6305, centre d'études des pathologies respiratoires, faculté de médicine François-Rabelais, 37032 Tours, France
| | - O Y Sow
- Service de pneumologie, hôpital Ignace-Deen, Conakry, Guinée
| | - S Marchand-Adam
- Service de pneumologie et explorations fonctionnelles respiratoires, CHU de Tours, 37032 Tours, France; Inserm U-1100/EA-6305, centre d'études des pathologies respiratoires, faculté de médicine François-Rabelais, 37032 Tours, France.
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Miyamoto R, Sano N, Tadano S, Inagawa S, Adachi S, Yamamoto M. Hepatic sarcoidosis mimicking cholangiocellular carcinoma: A case report and literature review. Int J Surg Case Rep 2017; 41:165-168. [PMID: 29080443 PMCID: PMC5686224 DOI: 10.1016/j.ijscr.2017.10.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Revised: 10/15/2017] [Accepted: 10/18/2017] [Indexed: 12/16/2022] Open
Abstract
The clinical and radiological findings of hepatic sarcoidosis are non-specific. Histopathological examination has been regarded as the definitive diagnostic tool. Surgery should be considered in case of difficulty to diagnose hepatic sarcoidosis.
Introduction Sarcoidosis is a multisystem disease characterized by the presence of non-caseating granulomas in affected organs. Almost 70% of patients with a sarcoidosis reaction have hepatic involvement. However, evidence-based clinical management or treatment strategies for hepatic sarcoidosis are poorly defined. Here, we present a case of a resected hepatic sarcoidosis patient. Additionally, we review the relevant hepatic sarcoidosis literature and discuss the clinical management of hepatic sarcoidosis. Presentation of case A 20-mm liver tumor of segment 8 was incidentally detected in a 64-year-old female. Radiological images resembled the enhancement pattern of cholangiocellular carcinoma. Thus, this lesion was assigned a preoperative classification of pT1N0M0 stage I according to the 7th Union for International Cancer Control guidelines. The patient underwent a partial liver resection. Histologically, the tumor contained sarcoidosis lesions indicated by a conglomerate of epithelioid granulomas with giant cells. These histopathological findings were consistent with the diagnosis of hepatic sarcoidosis. Discussion Histopathological examination has been established as the definitive diagnostic tool for hepatic sarcoidosis. Therefore, liver biopsy or surgical resection of a liver tumor should be considered in cases that are difficult to preoperatively distinguish from malignant tumors. Conclusion We present the case of a patient with surgically resected hepatic sarcoidosis that was difficult to preoperatively distinguish from cholangiocellular carcinoma.
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Affiliation(s)
- Ryoichi Miyamoto
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan.
| | - Naoki Sano
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Sosuke Tadano
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Satoshi Inagawa
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Shinya Adachi
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
| | - Masayoshi Yamamoto
- Department of Gastroenterological Surgery, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan
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Combes E, Foletti JM, Villeret J, Guyot L, Berbis P. [Differential diagnosis of basal cell carcinoma of the face: Dermatologist advice may avoid surgery]. ACTA ACUST UNITED AC 2016; 117:335-339. [PMID: 27424050 DOI: 10.1016/j.revsto.2016.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/23/2016] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Basal cell carcinoma (BCC) is the most common skin cancer in France. It is commonly diagnosed in front of a papule or nodule of the face. The surgeon should be able to question the diagnosis of BCC when nodular lesions are untypical, keeping in mind that some differential diagnoses require only medical treatment. OBSERVATIONS The authors successively describe three non infectious entities mimicking BCC of the face, requiring purely medical treatment: facial granuloma described by Lever, cutaneous pseudolymphoma, sarcoidosis. DISCUSSION In front of a non-typical skin nodule CBC, a dermatological expert advice may be quite helpful. The value of this collaboration is to guide or otherwise to suspend surgical excision.
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Affiliation(s)
- E Combes
- Aix Marseille université, 13916 Marseille, France; Service de dermatologie, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France
| | - J-M Foletti
- Aix Marseille université, IFSTTAR, LBA UMR_T 24, 13916 Marseille, France; Service de chirurgie maxillo-faciale, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France.
| | - J Villeret
- Aix Marseille université, 13916 Marseille, France; Service d'anatomopathologie, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France
| | - L Guyot
- Aix Marseille université, 13916 Marseille, France; Service de chirurgie maxillo-faciale, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France
| | - P Berbis
- Aix Marseille université, 13916 Marseille, France; Service de dermatologie, hôpital Nord, AP-HM, 13915 Marseille cedex 20, France
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Ennaifer R, Ayadi S, Romdhane H, Cheikh M, Nejma HB, Bougassas W, Hadj NB. Hepatic sarcoidosis: a case series. Pan Afr Med J 2016; 24:209. [PMID: 27795804 PMCID: PMC5072846 DOI: 10.11604/pamj.2016.24.209.7980] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 09/30/2015] [Indexed: 12/30/2022] Open
Abstract
Sarcoidosis is a systemic non caseous granulomas disease. Liver is a common location but usually asymptomatic. Evidence based guidelines for this location treatment is lacking and the effect of corticosteroids may be inadequate. The aim of our study was to describe the clinical, biochemical, radiological and therapeutic features of seven patients with systemic sarcoidosis and liver involvement. A retrospective and descriptive monocentric study, over 3 years, including seven patients with systemic sarcoidosis and liver involvement. We included 5 women and 2 men with an average age of 43 years. Hepatic localization revealed sarcoidosis in 5 cases. Hepatomegaly was observed in all patients as well as abnormal serum liver function test reflected by anicteric cholestasis. Liver biopsy, showed in all granulomatous lesions consistent with sarcoidosis and severe fibrosis in 2 cases. Extra-hepatic manifestations were present in all patients represented mainly by pulmonary location. All patients were treated, five by corticosteroid and two with ursodeoxycholic acid (UDCA). Complete response was observed in one case, partial response in another case and corticosteroid refractoriness in one case. In two cases, corticosteroid therapy was introduced for less than 1 month, not allowing assessment of response. Antimalarials in combination with UDCA were used successfully in a patient with steroid-resistant liver disease. Liver involvement can reveal systemic sarcoidois. Given the risk of progression to severe liver disease, it must be screened in all patients with systemic sarcoidosis. Treatment is not systematic, and still based on corticosteroid therapy. In the absence of prospective randomized controlled trials, the efficacy of UDCA need to be proven.
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Affiliation(s)
- Rym Ennaifer
- Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia
| | - Shema Ayadi
- Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia
| | - Hayfa Romdhane
- Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia
| | - Myriam Cheikh
- Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia
| | - Houda Ben Nejma
- Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia
| | - Wassila Bougassas
- Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia
| | - Najet Bel Hadj
- Department of Hepato-gastro-enterology, Mongi Slim Hospital, Tunis, Tunisia
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Mahfoudhi M, Mamlouk H, Turki S, Kheder A. Systemic sarcoidosis complicated of acute renal failure: about 12 cases. Pan Afr Med J 2015; 22:75. [PMID: 26834928 PMCID: PMC4725662 DOI: 10.11604/pamj.2015.22.75.6237] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 07/07/2015] [Indexed: 11/15/2022] Open
Abstract
The sarcoidosis is a systemic granulomatosis affecting most frequently the lungs and the mediastinum. An acute renal failure reveals exceptionally this disease. It's a retrospective study implicating 12 cases of sarcoidosis complicated of acute renal failure. The aim of this study is to determine epidemiological, clinical, biological and histological profile in these cases and then to indicate the interest to consider the diagnosis of sarcoidosis in cases of unexplained renal failure. Extra-renal complications, therapeutic modalities and the outcome were determined in all patients. Our series involved 12 women with an average age of 40 years. Biological investigations showed an abnormal normocalcemia in 7 cases, a hypercalcemia in 5 cases, a hypercalciuria in 10 cases and polyclonal hypergammaglobulinemia in 7 cases. An acute renal failure was found in all patients with a median creatinin of 520 umol/L. For all patients, the renal echography was normaln however, the kidney biopsy showed tubulo-interstitial nephritis. The extra-renal signs highlighting pulmonary interstitial syndrome in 5 cases, a sicca syndrome in 4 cases, mediastinal lymph nodes in 2 cases, a lymphocytic alveolitis in 3 cases, an anterior granulomatous uveitis in 2 cases and a polyarthritis in 5 cases. Five patients benefited of hemodialysis. The treatment consisted of corticosteroid in all cases. The follow up was marked by complete resolution of clinical and biological signs. The diagnosis of renal sarcoidosis must be done quickly to prevent renal failure.
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Affiliation(s)
- Madiha Mahfoudhi
- Internal Medicine A Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Habiba Mamlouk
- Internal Medicine A Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Sami Turki
- Internal Medicine A Department, Charles Nicolle Hospital, Tunis, Tunisia
| | - Adel Kheder
- Internal Medicine A Department, Charles Nicolle Hospital, Tunis, Tunisia
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Ennaifer R, Bacha D, Romdhane H, Cheikh M, Nejma HB, BelHadj N. Budd-Chiari Syndrome: An Unusual Presentation of Multisystemic Sarcoidosis. Clin Pract 2015; 5:768. [PMID: 26900444 PMCID: PMC4736049 DOI: 10.4081/cp.2015.768] [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: 02/28/2015] [Revised: 04/28/2015] [Accepted: 06/23/2015] [Indexed: 12/21/2022] Open
Abstract
Sarcoidosis is a multisystem granulomatous disease of unknown origin. All organs may be affected. Liver involvement is common but it is rarely symptomatic. Only a few cases of Budd-Chiari syndrome (BCS) secondary to a hepatic sarcoidosis have been described so far. We describe a case of multisystemic sarcoidosis presenting with BCS. A 42-year old female was referred to our department for chronic and anicteric cholestasis. Laboratory and imaging investigations disclosed features of chronic BCS associated with multisystemic sarcoidosis. The positive diagnosis was based on microscopic features, which showed hepatic, gastric and cutaneous non-caseating granulomas. Screening for an underlying thrombophilic disorder was negative. The diagnosis of BCS complicating hepatic sarcoidosis was the most likely. She was put on corticosteroids and anticoagulation therapy. To our knowledge, few cases of sarcoidosis-related BCS have been reported in the literature. In addition to being an uncommon presentation of sarcoidosis, this case illustrates the importance of recognizing an unusual cause of BCS and its therapeutic difficulties.
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Affiliation(s)
- Rym Ennaifer
- Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis
- Faculty of Medicine, University of Tunis El Manar, Tunis
| | - Dhouha Bacha
- Faculty of Medicine, University of Tunis El Manar, Tunis
- Department of Pathology, Mongi Slim Hospital, Tunis, Tunisia
| | - Hayfa Romdhane
- Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis
- Faculty of Medicine, University of Tunis El Manar, Tunis
| | - Myriam Cheikh
- Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis
- Faculty of Medicine, University of Tunis El Manar, Tunis
| | - Houda Ben Nejma
- Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis
- Faculty of Medicine, University of Tunis El Manar, Tunis
| | - Najet BelHadj
- Department of Hepato-Gastro-Enterology, Mongi Slim Hospital, Tunis
- Faculty of Medicine, University of Tunis El Manar, Tunis
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Toujani S, Mjid M, Ouahchi Y, Ben Salah N, Cherif J, Beji M. [Myelitis revealing sarcoidosis]. Rev Neurol (Paris) 2015; 171:740-2. [PMID: 26318904 DOI: 10.1016/j.neurol.2015.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 05/26/2015] [Indexed: 10/23/2022]
Affiliation(s)
- S Toujani
- Service de pneumologie allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El-Manar, CHU La Rabta, 1007, Tunis, Tunisie.
| | - M Mjid
- Service de pneumologie allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El-Manar, CHU La Rabta, 1007, Tunis, Tunisie
| | - Y Ouahchi
- Service de pneumologie allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El-Manar, CHU La Rabta, 1007, Tunis, Tunisie
| | - N Ben Salah
- Service de pneumologie allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El-Manar, CHU La Rabta, 1007, Tunis, Tunisie
| | - J Cherif
- Service de pneumologie allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El-Manar, CHU La Rabta, 1007, Tunis, Tunisie
| | - M Beji
- Service de pneumologie allergologie, unité de recherche 12SP06, faculté de médecine de Tunis, université de Tunis El-Manar, CHU La Rabta, 1007, Tunis, Tunisie
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11
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Dubrey SW, Sharma R, Underwood R, Mittal T. Cardiac sarcoidosis: diagnosis and management. Postgrad Med J 2015; 91:384-94. [PMID: 26130811 DOI: 10.1136/postgradmedj-2014-133219] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Accepted: 06/12/2015] [Indexed: 12/19/2022]
Abstract
Cardiac sarcoidosis is one of the most serious and unpredictable aspects of this disease state. Heart involvement frequently presents with arrhythmias or conduction disease, although myocardial infiltration resulting in congestive heart failure may also occur. The prognosis in cardiac sarcoidosis is highly variable, which relates to the heterogeneous nature of heart involvement and marked differences between racial groups. Electrocardiography and echocardiography often provide the first clue to the diagnosis, but advanced imaging studies using positron emission tomography and MRI, in combination with nuclear isotope perfusion scanning are now essential to the diagnosis and management of this condition. The identification of clinically occult cardiac sarcoidosis and the management of isolated and/or asymptomatic heart involvement remain both challenging and contentious. Corticosteroids remain the first treatment choice with the later substitution of immunosuppressive and steroid-sparing therapies. Heart transplantation is an unusual outcome, but when performed, the results are comparable or better than heart transplantation for other disease states. We review the epidemiology, developments in diagnostic techniques and the management of cardiac sarcoidosis.
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Affiliation(s)
- S W Dubrey
- Department of Cardiology, Hillingdon Hospital, Uxbridge, UK
| | - R Sharma
- Department of Cardiology, The Royal Brompton Hospital, London, UK
| | - R Underwood
- Department of Radiology, Harefield Hospital, Harefield, UK
| | - T Mittal
- Department of Radiology, Harefield Hospital, Harefield, UK
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Nathan N, Marcelo P, Houdouin V, Epaud R, de Blic J, Valeyre D, Houzel A, Busson PF, Corvol H, Deschildre A, Clement A. Lung sarcoidosis in children: update on disease expression and management. Thorax 2015; 70:537-42. [PMID: 25855608 DOI: 10.1136/thoraxjnl-2015-206825] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 03/16/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Sarcoidosis is a rare lung disease in children. The aim of the present study was to provide update information on disease presentation and progression, patient management and prognosis factors in a cohort of children with lung sarcoidosis. METHODS With the network of the French Reference Centre for Rare Lung Diseases (RespiRare), we collected information on a large cohort of paediatric thoracic sarcoidosis to provide information on disease presentation, management and outcome. RESULTS Forty-one patients were included with a median age at diagnosis of 11.8 years (1.1-15.8), mostly from Afro-Caribbean and Sub-Saharan origin. At diagnosis, 85% presented with a multi-organic disease, and no major differences were found regarding disease severity between the patients diagnosed before or after 10 years old. Corticosteroids were the most used treatment, with more intravenous pulses in the youngest patients. The 18-month outcome showed that patients diagnosed before 10 years old were more likely to recover (50% vs 29%), and presented fewer relapses (29% vs 58%). At 4-5 years of follow-up, relapses were mostly observed for patients diagnosed after 10 years old. DISCUSSION In the included children, mostly of Afro-Caribbean and Sub-Saharan origin, sarcoidosis seems severe, with multi-organic involvement and foreground general symptoms. Common prognosis factors are not suitable in paediatric patients, and a young age at diagnosis does not seem to be associated with a poorer prognosis. The study is ongoing to provide further information on the very-long-term follow-up of paediatric sarcoidosis.
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Affiliation(s)
- Nadia Nathan
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Paris, France Université Pierre et Marie Curie-Paris6, Paris, France UMR S-U933, Inserm, Paris, France
| | - Pierre Marcelo
- Pediatric Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Véronique Houdouin
- Pediatric Pulmonary Department, AP-HP, Hôpital Robert Debré, Paris, France
| | - Ralph Epaud
- Pediatric Department, Centre Hospitalier Intercommunal de Créteil, Créteil, France U955, Equipe 11, Inserm, Créteil, France Faculté de Médecine, Université Paris-Est, Créteil, France
| | - Jacques de Blic
- Pediatric Pulmonary Department, AP-HP, Hôpital Necker Enfants Malades, Paris, France Université Paris Descartes-Paris5, Paris, France
| | - Dominique Valeyre
- AP-HP, Hôpital Avicenne, Pulmonary Department and l'Université Paris 13, COMUE Sorbonne Paris Cité, EA 2363, Bobigny, France
| | - Anne Houzel
- Pediatric Department, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | | | - Harriet Corvol
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Paris, France Université Pierre et Marie Curie-Paris6, Paris, France UMR S-U933, Inserm, Paris, France
| | - Antoine Deschildre
- Pediatric Department, Centre Hospitalier Universitaire de Lille, Lille, France
| | - Annick Clement
- Pediatric Pulmonary Department, AP-HP, Hôpital Trousseau, Paris, France Université Pierre et Marie Curie-Paris6, Paris, France UMR S-U933, Inserm, Paris, France
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13
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Mahfoudhi M, Gorsane I, Battikh AG, Turki S, Kaaroud H, Goucha R, Hamida FB, Abdallah TB. Epidemiological, Clinical and Follow-Up Data in a Series of Thirteen Renal Insufficiencies Complicating Sarcoidosis. ACTA ACUST UNITED AC 2015. [DOI: 10.4236/ojcd.2015.52009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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14
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Quenardelle V, Benmekhbi M, Aupy J, Dalvit C, Hirsch E, Benoilid A. Neurosarcoïdose de présentation atypique. Rev Med Interne 2013; 34:776-9. [DOI: 10.1016/j.revmed.2013.02.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Revised: 01/26/2013] [Accepted: 02/18/2013] [Indexed: 01/19/2023]
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15
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Hilderson I, Van Laecke S, Wauters A, Donck J. Treatment of renal sarcoidosis: is there a guideline? Overview of the different treatment options. Nephrol Dial Transplant 2013; 29:1841-7. [DOI: 10.1093/ndt/gft442] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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16
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Balageas A, Sanguinet F, Lequen L, Delbrel X. Sarcoïdose musculaire : à propos d’un cas avec atteinte des muscles et des fascias et revue de la littérature. Rev Med Interne 2013; 34:706-12. [DOI: 10.1016/j.revmed.2013.02.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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17
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Denny MC, Fotino AD. The Heerfordt-Waldenström syndrome as an initial presentation of sarcoidosis. Proc (Bayl Univ Med Cent) 2013; 26:390-2. [PMID: 24082416 DOI: 10.1080/08998280.2013.11929014] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Sarcoidosis is a granulomatous disease of unclear etiology, which commonly presents with cough, dyspnea, chest pain, fever, weight loss, arthralgias, and erythema nodosum. Heerfordt-Waldenström syndrome, a rare presentation of sarcoidosis, is characterized by the presence of parotid gland enlargement, facial palsy, anterior uveitis, and fever. Here we present a case of a 59-year-old nonsmoking African American woman who presented with 3 days of progressively worsening left facial droop, difficulty swallowing, and blurred vision. Over the prior 4 months, she had had a productive cough, fevers, night sweats, and an unintentional 30-pound weight loss. Physical examination revealed a left facial droop involving the forehead, cheek, and chin with an inability to close the left eyelid. Her serum angiotensin-converting enzyme level was twice the upper limit of normal. Prominent hilar markings were identified on chest x-ray, but no focal opacity was seen. Fine-needle aspiration of a preauricular lymph node revealed noncaseating granulomas consistent with granulomatous lymphangitis. The patient was given a diagnosis of Heerfordt-Waldenström syndrome, or uveoparotid fever. Treatment with a high-dose steroid improved her parotid gland enlargement, facial palsy, and anterior uveitis.
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Affiliation(s)
- M Carter Denny
- Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana
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18
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Buss G, Cattin V, Spring P, Malinverni R, Gilliet M. Two cases of interferon-alpha-induced sarcoidosis Koebnerized along venous drainage lines: new pathogenic insights and review of the literature of interferon-induced sarcoidosis. Dermatology 2013; 226:289-97. [PMID: 23886768 DOI: 10.1159/000346244] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 11/26/2012] [Indexed: 11/19/2022] Open
Abstract
Sarcoidosis is a systemic granulomatous disorder of unknown origin commonly affecting the lung, the lymphoid system and the skin. We report here two cases of cutaneous sarcoidosis in two former intravenous drug users following interferon (IFN)-α and ribavirin therapy for chronic hepatitis C. Both patients developed skin sarcoidosis along venous drainage lines of both forearms, coinciding with the areas of prior drug injections. The unique distribution of the skin lesions suggests that tissue damage induced by repeated percutaneous drug injections represents a trigger for the local skin manifestation of sarcoidosis. Interestingly, skin damage was recently found to induce the local expression IFN-α, a well-known trigger of sarcoidosis in predisposed individuals. Here we review the literature on sarcoidosis elicited in the context of IFN-α therapy and propose a new link between the endogenous expression of IFN-α and the induction of disease manifestations in injured skin.
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Affiliation(s)
- G Buss
- Division of Immunology and Allergology, University of Lausanne, Lausanne, Switzerland
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19
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Bernard C, Maucort-Boulch D, Varron L, Charlier C, Sitbon K, Freymond N, Bouhour D, Hot A, Masquelet AC, Valeyre D, Costedoat-Chalumeau N, Etienne M, Gueit I, Jouneau S, Delaval P, Mouthon L, Pouget J, Serratrice J, Brion JP, Vaylet F, Bremont C, Chennebault JM, Jaffuel S, Broussolle C, Lortholary O, Sève P. Cryptococcosis in sarcoidosis: cryptOsarc, a comparative study of 18 cases. QJM 2013; 106:523-39. [PMID: 23515400 DOI: 10.1093/qjmed/hct052] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
AIM To describe the main characteristics and the treatment of cryptococcosis in patients with sarcoidosis. DESIGN Multicenter study including all patients notified at the French National Reference Center for Invasive Mycoses and Antifungals. METHODS Retrospective chart review. Each case was compared with two controls without opportunistic infections. RESULTS Eighteen cases of cryptococcosis complicating sarcoidosis were analyzed (13 men and 5 women). With 2749 cases of cryptococcosis registered in France during the inclusion period of this study, sarcoidosis accounted for 0.6% of all the cryptococcosis patients and for 2.9% of the cryptococcosis HIV-seronegative patients. Cryptococcosis and sarcoidosis were diagnosed concomitantly in four cases; while sarcoidosis was previously known in 14/18 patients, including 12 patients (67%) treated with steroids. The median rate of CD4 T cells was 145 per mm(3) (range: 55-1300) and not related to steroid treatment. Thirteen patients had cryptococcal meningitis (72%), three osteoarticular (17%) and four disseminated infections (22%). Sixteen patients (89%) presented a complete response to antifungal therapy. After a mean follow-up of 6 years, no death was attributable to cryptococcosis. Extra-thoracic sarcoidosis and steroids were independent risk factors of cryptococcosis in a logistic regression model adjusted with the sex of the patients. CONCLUSIONS Cryptococcosis is a significant opportunistic infection during extra-thoracic sarcoidosis, which occurs in one-third of the cases in patients without any treatment; it is not associated to severe CD4 lymphocytopenia and has a good prognosis.
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Affiliation(s)
- C Bernard
- Department of Internal Medicine, 103 Grande Rue de la Croix-Rousse, 69317 Lyon Cedex 04, France.
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20
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Rochoy M, Lefèvre G, Fontaine A, Boualit M, Le Roy P, Neugebauer Y, Chanson N, Le Gouellec N, Launay D, Lambert M, Hachulla E, Hatron PY. [Atypical gastritis]. Rev Med Interne 2013; 34:581-2. [PMID: 23478158 DOI: 10.1016/j.revmed.2013.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 01/07/2013] [Accepted: 02/04/2013] [Indexed: 11/25/2022]
Affiliation(s)
- M Rochoy
- Service de médecine interne, centre de référence pour les maladies auto-immunes et systémiques rares (sclérodermie systémique), CHRU de Lille, université Lille Nord-de-France, 59037 Lille, France
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21
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Sarcoïdose vertébrale. Évolution spontanément favorable : une observation et revue de la littérature. Rev Med Interne 2013; 34:42-6. [DOI: 10.1016/j.revmed.2012.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2012] [Revised: 08/22/2012] [Accepted: 09/02/2012] [Indexed: 11/20/2022]
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22
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Picque JB, Bouiller K, Gandon C, Vinit J, Muller G, Couailler J, Bielefeld P, Besancenot JF. Efficacité de l’infliximab dans le traitement d’une hypophysite lymphocytaire. Rev Med Interne 2012. [DOI: 10.1016/j.revmed.2012.10.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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23
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Stehlé T, Boffa JJ, Lang P, Desvaux D, Sahali D, Audard V. [Kidney involvement in sarcoidosis]. Rev Med Interne 2012; 34:538-44. [PMID: 23154110 DOI: 10.1016/j.revmed.2012.10.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Revised: 09/26/2012] [Accepted: 10/08/2012] [Indexed: 12/20/2022]
Abstract
Sarcoidosis is a chronic multisystemic inflammatory disorder of unknown etiology, characterized by the presence of non-necrotizing epithelioid and giant cell granulomas. Various renal manifestations have been reported in patients with sarcoidosis. Disorders of bone and mineral metabolism related to the overexpression of 25-hydroxyvitamin-D1α-hydroxylase by alveolar and granuloma macrophages are frequently associated with sarcoidosis. Hypercalcemia and hypercalciuria are a major cause of renal injury predisposing to pre renal azotemia, acute tubular necrosis, nephrolithiasis and nephrocalcinosis. Therapeutic management of hypercalcemia includes preventive measures (limited sunlight exposure, limited vitamin D and calcium intakes, and adequate hydration) and specific treatment in cases of severe hypercalcemia (corticosteroid therapy, chloroquine or ketoconazole). Granulomatous tubulointerstitial nephritis is the most common renal lesion associated with sarcoidosis leading to end stage renal disease in some patients. In these cases, interstitial fibrosis seems to appear early in the course of sarcoidosis and is a major prognostic factor requiring rapid corticosteroid therapy to reduce the risk of severe renal impairment. Membranous nephropathy seems to be the most frequent glomerular disease that may occur in association with sarcoidosis. Among kidney allograft recipients, the risk of recurrence of granulomatous tubulointerstitial nephritis is high and may have a negative impact on the graft survival.
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Affiliation(s)
- T Stehlé
- Inserm U955, service de néphrologie et transplantation, université Paris Est, hôpital Henri-Mondor, institut francilien de recherche en néphrologie et transplantation (IFRNT), AP-HP, 94010 Créteil, France.
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24
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Pruna L, Angioi K, Robin A, Deibener J, Poirson A, Selton J, Mohamed S, Kaminsky P. Uvéites révélant une sarcoïdose : caractéristiques cliniques à propos de 23 cas. Rev Med Interne 2012; 33:615-20. [DOI: 10.1016/j.revmed.2012.06.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 05/10/2012] [Accepted: 06/02/2012] [Indexed: 11/29/2022]
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25
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Elloumi H, Marzouk S, Tahri N, Bahloul Z, Azouz M. Sarcoïdose et atteinte hépatique : étude de 25 cas. Rev Med Interne 2012; 33:607-14. [DOI: 10.1016/j.revmed.2012.08.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 05/31/2012] [Accepted: 08/07/2012] [Indexed: 02/01/2023]
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26
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27
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Thalidomide for improving cutaneous and pulmonary sarcoidosis in patients resistant or with contraindications to corticosteroids. Biomed Pharmacother 2012; 66:300-7. [DOI: 10.1016/j.biopha.2012.03.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2011] [Accepted: 03/05/2012] [Indexed: 01/17/2023] Open
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28
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MEHTA BELLA, EFTHIMIOU PETROS. Radiographic Improvement in Sarcoid Arthropathy after Infliximab Treatment: Figure 1. J Rheumatol 2012; 39:664-5. [DOI: 10.3899/jrheum.111002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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29
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Current world literature. Curr Opin Ophthalmol 2011; 22:523-9. [PMID: 22005482 DOI: 10.1097/icu.0b013e32834cb7d7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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30
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Yamaguchi T. [108th Scientific Meeting of the Japanese Society of Internal Medicine: symposium: 2. Correlation between pulmonary diseases and whole body; (4) systemic involvements of sarcoidosis]. ACTA ACUST UNITED AC 2011; 100:2517-23. [PMID: 22117344 DOI: 10.2169/naika.100.2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Tetsuo Yamaguchi
- Department of Respiratory Medicine, Japan Railway Tokyo General Hospital, Japan
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31
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Bocoum AI, Daumas A, Cammilleri S, Bernard F, Rossi P, Bagneres D, Demoux AL, Aissi K, Dales JP, Berdah S, Chaumoitre K, Frances Y, Granel B. Péricardite récidivante révélant une sarcoïdose systémique. Rev Med Interne 2011; 32:575-9. [DOI: 10.1016/j.revmed.2011.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2010] [Revised: 01/17/2011] [Accepted: 03/10/2011] [Indexed: 10/17/2022]
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32
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Hermet M, le Guenno G, Rieu V, Philippe P, Ruivard M. [Nasosinusal and cervical sarcoidosis: a case series of three patients and literature review]. Rev Med Interne 2011; 33:46-9. [PMID: 21601318 DOI: 10.1016/j.revmed.2011.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2010] [Revised: 01/18/2011] [Accepted: 04/11/2011] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Sinonasal sarcoidosis is difficult to treat. Infliximab seems to be useful in the treatment of sarcoidosis of the upper respiratory tract. CASE SERIES We report three cases of sinonasal sarcoidosis in two women of 36 and 42-year-old and in a 64-year-old man. Resistance or dependence to corticosteroids and absence of efficacy of methotrexate therapy in one patient led to administer anti-TNFα therapy with infliximab. Outcome was favourable on sarcoid lesions but treatment was discontinued because of infectious complications and worsening of sarcoid chest involvement. CONCLUSION This case series suggests that infliximab might be useful for the treatment of sarcoidosis with sinonasal involvement.
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Affiliation(s)
- M Hermet
- Service de médecine interne, hôpital Estaing, CHU de Clermont-Ferrand, Clermont-Ferrand, France.
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