Requeno-Jarabo MN, Amorós-García R, Murillo-Díaz de Cerio II, Antoñanzas-Lombarte A. [Polyarthralgia as an initial symptom of sarcoidosis].
Semergen 2013;
39:325-9. [PMID:
24034761 DOI:
10.1016/j.semerg.2012.04.014]
[Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2011] [Revised: 04/03/2012] [Accepted: 04/05/2012] [Indexed: 11/25/2022]
Abstract
A 39 year-old patient consulted his family doctor due to migratory polyarthralgia, with C-reactive protein 7.99mg/dl, ESR 89mm and normal anti-streptolysin O (ASO). A sample was taken for analysis in the Rheumatology Clinic: ACE 72 IU, with normal rheumatoid factor, C-reactive protein and ASO; HLA non-specific. Chest X-ray showed an increased pulmonary interstitial pattern, and his chest-CT showed multiple bilateral pulmonary nodules and mediastinal lymph nodes. A differential diagnosis of lymphoproliferative process was considered. A gallium scintigraphy was performed with no relevant findings. The patient was referred to Thoracic Surgery for a lymph node biopsy by mediastinoscopy, which showed a non-necrotizing granulomatous lymphadenitis consistent with a sarcoidosis. Treatment with prednisone and anti-osteoporosis drugs was started and the patient was evaluated at four months with a new chest X-ray. There was a clinical and radiological remission therefore it was decided to gradually reduce the corticosteroid therapy.
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