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Journal articles on the topic 'Sarcoidoses'
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Hours, S., H. Nunes, M. Kambouchner, Y. Uzunhan, M. Brauner, D. Valeyre, and P. Y. Brillet. "Aspects tomodensitometriques (TDM) initiaux et evolutifs des sarcoidoses cavitaires." Journal de Radiologie 88, no. 10 (October 2007): 1356. http://dx.doi.org/10.1016/s0221-0363(07)81010-9.
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Bruguière, E., J. Marmursztejn, S. Silvera, H. Gouya, L. Guillevin, P. Legmann, and O. Vignaux. "Apports de l’IRM cardiaque dans le bilan des sarcoidoses." Journal de Radiologie 90, no. 10 (October 2009): 1430–31. http://dx.doi.org/10.1016/s0221-0363(09)75639-2.
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Paovic, Jelena, Predrag Paovic, and Miroslav Vukosavljevic. "Clinical and immunological features of retinal vasculitis in systemic diseases." Vojnosanitetski pregled 66, no. 12 (2009): 961–65. http://dx.doi.org/10.2298/vsp0912961p.
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Background/Aim. Vasculitis is a clinical, pathologic process characterized by inflammation and necrosis of blood vessel occurring anywhere in the body. The aim of the study was to present some clinical and immunologic features of retinal vasculitis in systemic diseases: systemic lupus erythematosus, multiple sclerosis, sarcoidosis, Behcet's diseases, and others. Methods. A total of 1 254 patients with uveitis were included in the study. The immunochemical diagnostic methods were used to determine the pathogenesis of ocular manifestations. Ocular manifestations were examined using biomicroscope, direct or indirect ophtalmoscopy. Results. Primary retinal vasculitis was diagnosed in 85/1254 (6.8%) of total uveitis. In more than half of the cases of vasculitis (58.8%), both arteries and veins were involved in inflammatory process. Periphlebitis was diagnosed far more commonly (36.5%) than periarteritis (4.7%). Retinal vasculitis associated with systemic lupus erythematosus was characterized by microinfarctions and the consequent foci of inflammatory cells or diseases of large arteries manifesting in vasospasm and occlusions. Cotton wool spots occurred in 38.3% and retinal hemorrhages in 34% of the cases. In this study periphlebitis of the retina was one of the less frequent ocular manifestations of multiple sclerosis. Comparing with the other changes of the retinal blood vessels, venous sheating occurred in 25.1% and occlusion and vein trombosis in 43.75% of the cases. Retinal vasculitis associated with chronic sarcoidosis occured in 37.5% of patients with sarcoidosis. The most frequent manifestation of ocular sarcoidosis was intermediary uveitis (43.75%). Anterior granulomatous uveitis occured in 37.5% of patients with sarcoidoses. Immune complexes occurred in 13/20 (65%) of the patients. Antiretinal anti-S antibody in the serum occurred in 73% of the patients with retinal detachment as a complication of primary disease and in 25% those with vasculitis. Conclusion. Systemic diseases such as Behcet's syndrome, collagen vascular diseases, systemic granulomatous diseases (sarcoidosis and tuberculosis) were the main causes of retinal vasculitis. Knowledge of the symptomatology and pathogenesis of retinal vasculitis is of the major significance for the diagnosis and therapy of the disease.
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Nawfal, Georges, Christelle Budin, Raymonde Bouvier, and Alain Lachaux. "Elevated Aminotransaminases As the First Manifestation of Sarcoidosis." Case Reports in Medicine 2009 (2009): 1–3. http://dx.doi.org/10.1155/2009/193785.
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Sarcoidose is a rare disease in children. The aminotransaminase level is often normal to moderately elevated (2 to 3 folds of the normal level). We report the case of a child who presented an aminotransaminase level that was 10 times the normal level, as the first manifestation of sarcoidosis.
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Studdy, P. R., and R. Bird. "Serum Angiotensin Converting Enzyme in Sarcoidosis—Its Value in Present Clinical Practice." Annals of Clinical Biochemistry: International Journal of Laboratory Medicine 26, no. 1 (January 1989): 13–18. http://dx.doi.org/10.1177/000456328902600102.
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Angiotensin converting enzyme (ACE) has a central role in blood pressure homeostasis. It is present in low and fairly constant concentration in the serum and in high concentration in the pulomonary capillary bed. Unusually high serum angiotensin converting enzyme (SACE) activity is present in active sarcoidosis, an observation now confirmed by many investigators. In spite of its lack of specificity as a test for sarcoidoisis, SACE provides a good monitor of disease activity which clinicians find useful in the management of patients with sarcoidosis. There continues to be considerable interest in SACE in sarcoidosis and with the recent development of simpler assays, more centres may be expected to offer SACE measurements as a service. In this paper we discuss the indications for estimating SACE in sarcoidosis and its relevance to current clinical practice.
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Saylor, Catherine, Nabil Beaini, James Rokos, Keerthana Satheesh, and Charles Cobb. "Primary Manifestation of Sarcoidosis Involving the Gingivae." International Journal of Experimental Dental Science 1, no. 2 (2012): 102–5. http://dx.doi.org/10.5005/jp-journals-10029-1025.
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ABSTRACT Sarcoidois of the gingiva is rarely the primary manifestation of the disease. The following case presentation highlights clinical signs and symptoms that are not uncommon or unusual except for the anatomical location of the initial expression. Appropriate treatment must be based on a definitive diagnosis which, in turn, requires a biopsy for histologic analysis. How to cite this article Saylor C, Beaini N, Rokos J, Satheesh K, Cobb C. Primary Manifestation of Sarcoidosis Involving the Gingivae. Int J Experiment Dent Sci 2012;1(2):102-105.
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Kapoor, Ashutosh, and Ambar Basu. "Hypercalcemia- A Common Abnormality With Uncommon Etiologies." Journal of the Endocrine Society 5, Supplement_1 (May 1, 2021): A198. http://dx.doi.org/10.1210/jendso/bvab048.402.
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Abstract Introduction: Hypercalcemia is a relatively common electrolyte abnormality which is generally associated with Parathyroid related disorders or Cancers. Rare aetiologies comprise of granulomatous disorders and haematological malignancies namely Sarcoidosis and Lymphoma. Parathyroid hormone related Peptide (PTH-rp) and Calcitriol are implicated in causing Hypercalcemia in mentioned aetiologies. Case Details: A 57 year gentleman was admitted following a 10 day history of feeling unwell, unsteadiness in gait, constipation and mild shortness of breath (SOB) on walking uphill. His medical history comprised of Type 1 Diabetes Mellitus (DM) and Hypertension (HTN). Regular medications did not comprise of any drugs that could lead to Hypercalcemia. Biochemic he was Hypercalcemic at 3.14 (2.20–2.60). Parathyroid Hormone levels (PTH) was 0.6 (1.1–4.7 pmol/l) which excluded Parathyroid driven aetiologies. ACE levels were normal and Myeloma screen was negative. 25-OH Vitamin D levels were within Normal limits. Management: Hypercalcemia was managed with Intravenous Fluids and optimum hydration which improved his Calcium levels, followed by subsequent normalisation. Given his suppressed PTH levels, he underwent whole body imaging to assess for evidence of underlying occult malignancy. The CT imaging of his chest, abdomen and pelvis revealed widespread Lymphadenopathy and hypodense lesions in the Spleen. The report stated likely Sarcoidosis accompanied by Splenic involvement, with the main differentials being Sarcoidois versus Lymphoproliferative disorder. This was discussed with the respiratory team and Steroids were not commenced taking into account the improvement in his Calcium levels following adequate hydration and fluids. The patient has been kept under close follow up with ongoing monitoring of his clinical status. Summary: Hypercalcemia has been described in patients with Granulomatous disorders and Haematological malignancies. The incidence of hypercalcemia in Sarcoidosis is estimated to be approximately 10%, with no association with a specific demographic. Granulomatous disorders and Haematological malignancies constitute the rare aetiologies of hypercalcemia and are characterised by a low-normal or suppressed PTH level. Diagnosis of Sarcoidosis is often challenging with the lack of gold standard tests. Serum ACE levels can be within normal limits in people with Sarcoidosis despite not being on Steroid therapy. Evaluation of serum PTH-rp and Calcitriol can aid in diagnosis and more importantly assisting in prognostication, thus guiding further management.
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Mahévas, Matthieu, Laurent Chiche, Medhi Khellaf, Yurdagu Uzunhan, Anne-Sophie Morin, Véronique Perronne, Louis Affo, et al. "Characteristics of Sarcoidosis-Associated Immune Thrombocytopenia: a Consecutive Study of 20 Cases." Blood 114, no. 22 (November 20, 2009): 2407. http://dx.doi.org/10.1182/blood.v114.22.2407.2407.
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Abstract Abstract 2407 Poster Board II-384 Introduction: Although sarcoidosis is far from being a classical cause of secondary-immune thrombocytopenic purpura (ITP), isolated thrombocytopenia may occur during the course of the disease. To better assess the main characteristics and outcome of patients with a sarcoidosis-associated ITP, a survey was initiated throughout the French study group on sarcoidosis and the national referral center for adult's immune cytopenias. The data of the 20 first cases are reported. Patients and Methods: To be included, all patients had to fulfil the following criteria: 1) Definite diagnosis of sarcoidosis according to the standard international criteria (Am J Respir Crit Care Med 1999; 736-55) and 2) Presence of an immune thrombocytopenia according to the ASH criteria twith platelet count below 100 × 109/L on at least two separate occasions 2 weeks. Drug-induced thrombocytopenia were excluded as well as patients with a hypogammaglobulinemia suggesting a underlying common variable immunodeficiency (CVI) and thrombocytopenia related to hypersplenism. All clinical and biological data were reviewed and analyzed by the same investigator by using a standard form. A complete response (CR) was defined as sustained (> 3months) platelet count > 100 × 109/L with at least a twofold increase for baseline. A partial response (PR) was defined as a platelet count 30×109/L or more and at least twice the initial value. Results: Twenty patients (50% men) were included. Median age at ITP diagnosis was 37.5 years (21 to 83) and median age at sarcoidosis diagnosis was 36 yrs (10 to 83). In 4 patients, ITP preceded the diagnosis of sarcoidosis (median: 67.5 months; 15 to 153). In 11 patients (55%), ITP occurred in the course of prior diagnosed sarcoidosis with a median of 48 mths (6 to 216), and concomitantly with the diagnosis of sarcoidosis in 5 patients (25%). In 13 patients (65%), an active localization of sarcoidosis was present at the diagnosis of ITP. Median platelet count at onset was 11×109/L (3 to 90) and nadir platelet count was 10×109/L (1 to 60). Seven patients (35%) had severe (mucosal) bleeding manifestations and a bleeding score ≥ 8 (described by Khellaf et al). Regarding sarcoidosis, during the follow up, 17 patients (85%) had thoracic involvement, and an extra-thoracic involvement was found in 14 patients (70%) including: eye (n=7), liver (n=5), sinus (n=4), peripheral lymph nodes (n=4), skin (n=3), salivary gland (n=2), spleen (n=1) and kidney (n=1). Nineteen out of the 20 patients were treated specifically for their secondary ITP. After the first line therapy (prednisone at 1mg/kg/day for at least 3 consecutive weeks in all patients associated with IVIg in 10 patients), 12/19 (63%) patients achieved a complete response (CR), 6 a partial response (PR) (32%) and only 1 patient failed to respond. The course of ITP was chronic in 4 patients, among them 2 underwent splenectomy and achieved a CR and 2 were treated with Rituximab (375mg/m2, 4 infusions) and achieved a PR at one year. After a median follow up of 70 months (12 to142), 18 patients (90%) were in CR and 2 in PR with chronic ITP. Eight patients were in remission off therapy whereas 12 patients (60%) were still on corticosteroids at time of analysis with a median dose of 10mg/day (5 to 30). During the follow-up period, 11 patients (55%) had a relapse or flare of sarcoidosis (intra thoracic in 5 patients, extra-thoracic in 6 patients). In 2 patients, a simultaneous relapse of both sarcoidoisis and associated-ITP was observed. Comments: Our preliminary data suggest that the association of sarcoidosis and ITP is not fortuitous and that sarcoidosis should be considered as a potential cause of secondary ITP. ITP in this setting is frequently initially severe and symptomatic and therefore requiring treatment. The overall response rate to treatments commonly used in primary ITP is however good and the long term outcome is favorable suggesting that patients with sarcoidosis-associated ITP should be managed as patients with primary ITP. In contrast, relapse of sarcoidosis is frequent and frequently affect extra-thoracic sites. That a majority of the patients had an active and/or relapsing sarcoidosis during the course of ITP suggests that granuloma may be a predisposing condition for triggering autoimmunity and especially ITP as observed in some cases of CVI-associated immune thrombocytopenia. Disclosures: No relevant conflicts of interest to declare.
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Akimov, V. G. "Manifestations of Besnier-Boeck-Schaumann sarcoidosis on skin." Medical alphabet, no. 6 (June 16, 2020): 83–86. http://dx.doi.org/10.33667/2078-5631-2020-6-83-86.
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Besnier-Boeck-Schaumann sarcoidosis is a multisystemic disease of unknown etiology. Only about 25 % of patients have cutaneous involvement. Every patient with cutaneous sarcoidosis should be evaluated for possible systemic sarcoidosis. This article contains descriptions and original images of clinical forms of the disease: miliary sarcoidosis, circinate sarcoidosis, nodular sarcoidosis, angiolupoid (Brocq-Potrier), lupus pernio (Besnier-Tennesson), erythema nodosum, subcutaneous sarcoidosis (Darier-Roussy). Differential diagnosis and treatment of patients are discussed.
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Chen, Jacob, Robert Carter III, Daniel Maoz, Ana Tobar, Eran Sharon, and Franklin Greif. "Breast Cancer and Sarcoidosis: Case Series and Review of the Literature." Breast Care 10, no. 2 (2015): 137–40. http://dx.doi.org/10.1159/000381324.
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Background: Sarcoidosis is a chronic inflammatory disease of unknown etiology, which can involve different organs and systems. Accordingly, sarcoidosis can mimic breast cancer, making the differential diagnosis very difficult. Case Report: 5 patients with a diagnosis of both sarcoidosis and breast cancer followed by the Rabin Medical Center between January 1993 and June 2012 were enrolled in this study. Additionally, a comprehensive literature review which identified 104 patients diagnosed with breast cancer and sarcoidosis was carried out. In both populations reviewed, the average age at diagnosis of sarcoidosis and breast cancer was 57 years. Among the 66 patients with both sarcoidosis and breast cancer, sarcoidosis preceded breast cancer in 31 cases, followed it in 23 cases, and appeared concurrently in 10 cases. Conclusion: Based on our clinical cases and literature review, a histological study is recommended over imaging if sarcoidosis or breast cancer may be present. Furthermore, breast cancer is rarely associated with sarcoidosis or sarcoidosis-like reaction.
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Sholomova, V. I., E. A. Saginova, A. V. Balatckii, L. M. Samohodskaia, M. Yu Brovko, L. Frantcuzevich, T. N. Krasnova, M. V. Lebedeva, V. V. Kraeva, and N. А. Muhin. "RENAL DYSFUNCTION IN PATIENTS WITH SARCOIDOSIS WITH OVERWEIGHT." Nephrology (Saint-Petersburg) 21, no. 2 (March 3, 2017): 41–47. http://dx.doi.org/10.24884/1561-6274-2017-21-2-41-47.
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THE AIM: to investigate presence of renal dysfunction in patients with sarcoidosis with overweight. PATIENTS AND METHODS: 46 patients with sarcoidosis (without signs of primary kidney and severe cardiovascular pathology) were divided into 4 groups: 1st – with obesity and active sarcoidosis, 2nd – without obesity with active sarcoidosis, 3rd – with obesity without active sarcoidosis, 4th –without obesity and active sarcoidosis. RESULTS: Negative impacts of obesity and sarcoidosis activity on GFR were found. The lowest GFR was observed in 1st group (71±10 ml/min), significantly higher – in 2nd and 3rd groups (83±8 and 82±8 ml/min) and the highest – in 4th group (110±13 ml/min). CONCLUSION: Obesity in sarcoidosis is associated with renal dysfunction.
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Tokala, Hemasri, Karthik Polsani, and Jagadeesh K. Kalavakunta. "Gastric Sarcoidosis: A Rare Clinical Presentation." Case Reports in Gastrointestinal Medicine 2013 (2013): 1–3. http://dx.doi.org/10.1155/2013/260704.
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Gastrointestinal (GI) sarcoidosis is a very rare disease, which clinically presents along with systemic disease or as an isolated finding. Gastric sarcoidosis is the most common form of GI sarcoidosis. Symptomatic gastric sarcoidosis is rare and only few case reports have been described in the literature with well-documented histological evidence of noncaseating granulomas. We present an interesting case of gastric sarcoidosis in a 39-year-old Caucasian man with symptoms of epigastric pain and profound weight loss. His endoscopic gastric mucosal biopsies revealed noncaseating granulomas consistent with gastric sarcoidosis. Treatment with oral steroids alleviated his symptoms with no recurrence in 2 years. Gastric sarcoidosis should be considered in patients with history of sarcoidosis and GI symptoms.
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Barletta, Pamela, Mukunthan Murthi, Douglas Salguero, and Mehdi Mirsaeidi. "Sarcoidosis as a paraneoplastic syndrome for breast cancer." Journal of Clinical Oncology 37, no. 15_suppl (May 20, 2019): e12587-e12587. http://dx.doi.org/10.1200/jco.2019.37.15_suppl.e12587.
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e12587 Background: Sarcoidosis is a multisystem granulomatous disease of unknown etiology. The pathogenesis of sarcoidosis is believed to be a result from a cellular immune reaction from exposure to occupational, environmental, or infectious elements that lead to the formation of noncaseating granulomas. Non-caseating granulomas are also present in cancer , and it is well known that the cancer cells carry neo-antigens, leading to a possible association between cancer and sarcoidosis. Several studies have shown an increased risk of breast cancer , in particular, in patients with sarcoidosis, but only a few studies have analyzed the incidence of sarcoidosis following breast cancer diagnosis. The present study aimed to identify patients with sarcoidosis following a diagnosis of breast cancer in our cohort of sarcoidosis. Methods: This is a retrospective case-series study between 2008-2018 of patients with sarcoidosis in the University of Miami Sarcoidosis Program. Sarcoidosis was defined per the World Association for Sarcoidosis and other Granulomatous Disorders guidelines. Breast cancer diagnosis was confirmed through pathology. We collected demographic data of age, gender, ethnicity and the time between diagnosis of breast cancer and sarcoidosis by chart review. Clincial data including clinical manifestations, laboratories, staging, and treatment were also collected. Results: Among 125 patients in our registry, 26 patients had a diagnosis of both cancer and sarcoidosis. In this, 12 (46%) developed sarcoidosis after the diagnosis of breast cancer and are the study population. Among them, 12(100%) were female. The most common ethnic group in the study population was European American with 8(67%) followed by African Americans 2(16.7%) and Hispanic 2(16.7%). Eight (67%) patients were treated with chemotherapy, 7(58%) with radiotherapy, of this, 6 (50%) received both. Mean (SD) age of onset of sarcoidosis was 61.9 ( 10.8) years . The mean time interval between breast cancer diagnosis and the onset of sarcoidosis was 5.58 ( 5.24) years ( (see Figure 1). Nine (75%) had pulmonary sarcoidosis and 3(25%) cardiac sarcoidosis. Among the subjects with pulmonary sarcoidosis 1(11.1%) had Stage 4, 4(44.4%) had Stage 2 and 4(44.4%) had stage 1. Conclusions: Our findings suggest sarcoidosis may be a paraneoplastic characteristic of breast cancer. The mechanism of granuloma development remains unclear. Cancer mediated immune dysregulation could be a potential contributing factor. Further studies are warranted to establish a definitive association.
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Sayah, David, Jason Bradfield, John Moriarty, John Belperio, and Joseph Lynch. "Cardiac Involvement in Sarcoidosis: Evolving Concepts in Diagnosis and Treatment." Seminars in Respiratory and Critical Care Medicine 38, no. 04 (July 27, 2017): 477–98. http://dx.doi.org/10.1055/s-0037-1602381.
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AbstractClinically evident sarcoidosis involving the heart has been noted in at least 2 to 7% of patients with sarcoidosis, but occult involvement is much higher (> 20%). Cardiac sarcoidosis is often not recognized antemortem, as sudden death may be the presenting feature. Cardiac involvement may occur at any point during the course of sarcoidosis and may occur in the absence of pulmonary or systemic involvement. Sarcoidosis can involve any part of the heart, with protean manifestations. Prognosis of cardiac sarcoidosis is related to the extent and site(s) of involvement. Most deaths due to cardiac sarcoidosis are due to arrhythmias or conduction defects, but granulomatous infiltration of the myocardium may be lethal. The definitive diagnosis of isolated cardiac sarcoidosis is difficult. The yield of endomyocardial biopsies is low; treatment of cardiac sarcoidosis is often warranted even in the absence of histologic proof. Radionuclide scans are integral to the diagnosis. Currently, 18F-fluorodeoxyglucose–positron emission tomography/computed tomography and gadolinium-enhanced magnetic resonance imaging scans are the key imaging modalities to diagnose cardiac sarcoidosis. The prognosis of cardiac sarcoidosis is variable, but mortality rates of untreated cardiac sarcoidosis are high. Although randomized therapeutic trials have not been done, corticosteroids (alone or combined with additional immunosuppressive medications) remain the mainstay of treatment. Because of the potential for sudden cardiac death, implantable cardioverter defibrillators should be placed in any patient with cardiac sarcoidosis and serious ventricular arrhythmias or heart block, and should be considered for cardiomyopathy. Cardiac transplantation is a viable option for patients with end-stage cardiac sarcoidosis refractory to medical therapy.
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Sheng, Youyu, Yuxin Yang, Yun Wu, and Qinping Yang. "Exploring the dynamic changes between pulmonary and cutaneous sarcoidosis based on gene expression." médecine/sciences 34 (October 2018): 121–33. http://dx.doi.org/10.1051/medsci/201834f121.
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Sarcoidosis is a disease involving the growth of abnormal inflammatory granulomas and affecting multisystems. It has an unknown etiology. The lung and the skin are the most commonly involved organs. Although large amounts of research have focused on the pathogenesis of sarcoidosis, little is known about the link between cutaneous sarcoidosis and pulmonary sarcoidosis. Moreover, the gene expression profiles provide a novel way to find diagnostic or prognostic biomarkers. Therefore, the aim of this study was to analyze the differentially expressed genes (DEGs) in pulmonary sarcoidosis and cutaneous sarcoidosis patients and to compare them to healthy individuals. DEGs and their biological functions are dynamically dysregulated, and several common disease-related genes and mutual disease progression-related genes were identified which linked pulmonary sarcoidosis and cutaneous sarcoidosis together. The biological functional pathways regulated by these DEGs may allow to define the common mechanism shared by different type of sarcoidosis, providing novel insight into the common pathogenesis of sarcoidosis and opening the way to the development of new therapeutic strategies.
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Harsányi, Emese, Klaudia Preisz, Erzsébet Temesvári, Sarolta Kárpáti, Judit Hársing, and Enikő Kuroli. "A case of sarcoidosis after cosmetics tattoo." Bőrgyógyászati és Venerológiai Szemle 91, no. 2 (April 29, 2015): 77–82. http://dx.doi.org/10.7188/bvsz.2015.91.2.3.
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Mosses, Sandra. "Sarcoidosis: A Great Masquerader-Case Report." Journal of Medical Science And clinical Research 05, no. 04 (April 2, 2017): 19800–19802. http://dx.doi.org/10.18535/jmscr/v5i4.15.
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Brahim, H. Ben. "Tuberculosis or Sarcoidosis a Case Report." Archives of Medical Case Reports and Case Study 4, no. 1 (April 9, 2021): 01–05. http://dx.doi.org/10.31579/2694-0248/027.
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Distinguishing sarcoidosis from pulmonary tuberculosis can be a great challenge to physicians, especially in Tunisia where there is high prevalence of tuberculosis. Both tuberculosis and sarcoidosis are granulomatous diseases; however, necrosis is commun in tuberculosis and less commun in sarcoidosis. The presence of necrosis may lead to an excessive diagnosis of tuberculosis. We present the case of a 48 years old female in which nasosinusal tuberculosis was retained face to granulomatous inflammation with little fields of necrosis. The patient was treated for many months without healing. The diagnosis was revised when evolutive pulmonary lesions were observed while the patient was under well conducted anti-tubercular treatment. Sarcoidosis was in fine retained with good response to corticosteroid therapy.
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Fidler, Lee M., Meyer Balter, Jolene H. Fisher, Teresa To, Matthew B. Stanbrook, and Andrea Gershon. "Epidemiology and health outcomes of sarcoidosis in a universal healthcare population: a cohort study." European Respiratory Journal 54, no. 4 (August 7, 2019): 1900444. http://dx.doi.org/10.1183/13993003.00444-2019.
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Sarcoidosis-related mortality appears to be rising in North America, with increasing rates in females and the elderly. We aimed to estimate trends in sarcoidosis incidence, prevalence and mortality in Ontario, Canada.We performed a cohort study using health administrative data from Ontario between 1996 and 2015. International Classification of Diseases and Ontario Health Insurance Plan codes were used for case detection. Three disease definitions were created: 1) sarcoidosis, two or more physician claims within 2 years; 2) chronic sarcoidosis, five or more physician claims within 3 years; and 3) sarcoidosis with histology, two or more physician claims with a tissue biopsy performed between claims.Overall, 18 550, 9199 and 3819 individuals with sarcoidosis, chronic sarcoidosis and sarcoidosis with histology, respectively, were identified. The prevalence of sarcoidosis was 143 per 100 000 in 2015, increasing by 116% (p<0.0001) from 1996. The increase in age-adjusted prevalence was higher in males than females (136% versus 99%; p<0.0001). The incidence of sarcoidosis declined from 7.9 to 6.8 per 100 000 between 1996 and 2014 (15% decrease; p=0.0009). A 30.3% decrease in incidence was seen among females (p<0.0001) compared with a 5.5% increase in males (p=0.47). Age- and sex-adjusted mortality rates of patients with sarcoidosis rose from 1.15% to 1.47% between 1996 and 2015 (28% increase; p=0.02), with the overall trend being nonsignificant (p=0.39). Mortality rates in patients with chronic sarcoidosis increased significantly over the study period (p=0.0008).The prevalence of sarcoidosis is rising in Ontario, with an apparent shifting trend in disease burden from females to males. Mortality is increasing in patients with chronic sarcoidosis.
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Judson, Marc. "Quality of Life in Sarcoidosis." Seminars in Respiratory and Critical Care Medicine 38, no. 04 (July 27, 2017): 546–58. http://dx.doi.org/10.1055/s-0037-1602589.
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AbstractHealth-related quality of life (HRQL) is an important aspect of patient evaluation. HRQL is particularly important in sarcoidosis, where treatment decisions are often based on HRQL impairment. HRQL assessment in sarcoidosis must take into account not only the direct effects of the disease but also the disease's psychosocial and emotional impact as well as the potential toxicity of therapy. Patient-reported outcomes (PROs) have been used to assess HRQL in sarcoidosis cohorts. Recent HRQL PROs have been developed that are sarcoidosis-specific and have adequate resolution to be used for monitoring individual patients potentially. In this article, the approach to HRQL assessment in sarcoidosis is discussed. This article focuses on the general approach to HRQL assessment, specific sarcoidosis issues concerning HRQL assessment, the construction of HRQL PROs, and their application in sarcoidosis. Several HRQL issues in sarcoidosis will be specifically highlighted, including parasarcoidosis syndromes, sarcoidosis-induced fatigue, and the impact of corticosteroid therapy.
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Judson, Marc A. "Screening Sarcoidosis Patients for Occult Disease." Seminars in Respiratory and Critical Care Medicine 41, no. 05 (August 10, 2020): 741–57. http://dx.doi.org/10.1055/s-0040-1709496.
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AbstractAs sarcoidosis may involve any organ, sarcoidosis patients should be evaluated for occult disease. Screening for some organ involvement may not be warranted if it is unlikely to cause symptoms, organ dysfunction, or affect clinical outcome. Even organ involvement that affects clinical outcome does not necessarily require screening if early detection fails to change the patient's quality of life or prognosis. On the other hand, early detection of some forms of sarcoidosis may improve outcomes and survival. This manuscript describes the approach to screening sarcoidosis patients for previously undetected disease. Screening for sarcoidosis should commence with a meticulous medical history and physical examination. Many sarcoidosis patients present with physical signs or symptoms of sarcoidosis that have not been recognized as manifestations of the disease. Detection of sarcoidosis in these instances depends on the clinician's familiarity with the varied clinical presentations of sarcoidosis. In addition, sarcoidosis patients may present with symptoms or signs that are not related to specific organ involvement that have been described as parasarcoidosis syndromes. It is conjectured that parasarcoidosis syndromes result from systemic release of inflammatory mediators from the sarcoidosis granuloma. Certain forms of sarcoidosis may cause permanent and serious problems that can be prevented if they are detected early in the course of their disease. These include (1) ocular involvement that may lead to permanent vision impairment; (2) vitamin D dysregulation that may lead to hypercalcemia, nephrolithiasis, and permanent kidney injury; and (3) cardiac sarcoidosis that may lead to a cardiomyopathy, ventricular arrhythmias, heart block, and sudden death. Screening for these forms of organ involvement requires detailed screening approaches.
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Suchankova, M., J. Urban, M. Ganovska, E. Tibenska, K. Szaboova, E. Tedlova, F. Sandor, et al. "TREM-1 and TREM-2 Expression on CD14+ Cells in Bronchoalveolar Lavage Fluid in Pulmonary Sarcoidosis and Hypersensitivity Pneumonitis in the Context of T Cell Immune Response." Mediators of Inflammation 2020 (May 14, 2020): 1–9. http://dx.doi.org/10.1155/2020/9501617.
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Background. Sarcoidosis and hypersensitivity pneumonitis (HP) are immunologically mediated processes caused by hypersensitivity reaction accompanied by similar features including lymphocytic alveolitis and granuloma formation. Recent studies describe the role of TREM receptors in T cell activation, differentiation, and granuloma formation. Alveolar macrophages activation via TREM receptors may be the key factor mediating subsequent immune response. The aim of the study was to analyse TREM-1 and TREM-2 expression to identify further molecular mechanisms participating in the immunopathogenesis of sarcoidosis and HP. Methods. Flow cytometry was performed to analyse TREM-1 and TREM-2 expression on CD14+ cells in bronchoalveolar lavage fluid from patients having sarcoidosis or HP and a control group. Results. The study proved increased TREM-1 expression on alveolar macrophages in pulmonary sarcoidosis and diminished TREM-1 expression in HP-Sarcoidosis: median: 76.7; HP: median: 29.9; control: median: 53.3, (sarcoidosis versus HP: p<0.001; sarcoidosis versus control: p<0.05). TREM-2 expression was increased in both, sarcoidosis and HP-sarcoidosis: median: 34.79; HP: median: 36.00; control: median: 12.98, (sarcoidosis versus control: p<0.05; HP versus control: p<0.05). Correlation analysis showed negative correlation between TREM-1 and total number of CD8+ cytotoxic T cells. In sarcoidosis TREM-1 expression decreased with changes of HRCT image, decrease in CD4/CD8 ratio and decrease in DLCO. Conclusions. Differences in TREM receptor expression in sarcoidosis (increase in TREM-1 and TREM-2) and HP (increase in TREM-2) and correlation analysis suggests that activation via TREM may participate in typical immunological characteristics of sarcoidosis and HP.
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Maderal, Andrea D., Daniel G. Federman, and Robert S. Kirsner. "Granulomatous Mastitis as a Presentation of Sarcoidosis." SKIN The Journal of Cutaneous Medicine 2, no. 1 (January 2, 2018): 85–89. http://dx.doi.org/10.25251/skin.2.1.14.
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Sarcoidosis is an idiopathic inflammatory disease characterized by granuloma formation in various tissues, most commonly the lungs, lymphatics, skin and eyes. Involvement of the breast in sarcoidosis is rare, and can be defined into three subsets, including granulomas localized to the breast, referred to as breast sarcoidosis. Breast sarcoidosis may present with systemic findings such as erythema nodosum, arthritis, and uveitis, and unlike typical sarcoidosis, commonly manifests during pregnancy. In this report, we present a rare case of breast sarcoidosis presenting in a pregnant female with associated erythema nodosum, arthralgias and ocular complaints.
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Morand, Meggie, Solange Beauregard, and Steve Mathieu. "Systemic Sarcoidosis Revealed by Axillary Electrolysis." Journal of Cutaneous Medicine and Surgery 19, no. 4 (March 2, 2015): 404–6. http://dx.doi.org/10.1177/1203475415575016.
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Background: Sarcoidosis is a noncaseating granulomatous disease that affects a large variety of organs and tissues. Skin sarcoidosis is commonly found in scar and tattooed tissues. Objective: To report this particular case of sarcoidosis following electrolysis hair removal. Method: We report the case of a woman who developed sarcoidosis years after axillary electrolysis hair removal. Results: The diagnosis of cutaneous sarcoidosis was suggested by the clinical manifestations and confirmed by histopathologic findings. Conclusion: Sarcoidosis should be considered during the investigation of skin lesions occurring in scar or traumatized tissue.
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Alwafi, Samar, Razan Alluhaibi, Sahar Alsharif, and Bader AlOmair. "Atypical Early Onset Juvenile Sarcoidosis Presenting with Osteolytic Lesions." POJ Clinical Case Reports 1, no. 1 (August 31, 2018): 1–4. http://dx.doi.org/10.32648/2639-3298/1/1/005.
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Sarcoidosis is a potentially fatal systemic inflammatory granulomatous disease, can occur in adult and pediatric patients, but it is relatively rare in children. Juvenile sarcoidosis has a diverse clinical course depending on the age of onset. Bone involvement is rarely noted in children with sarcoidosis and usually seen late in the course of the disease and is rarely the initial manifestation. Here we report a case of early onset juvenile sarcoidosis revealed by cutaneous and osseous lytic lesions of the phalanges. Keywords: Atypical, Early onset, Juvenile, Sarcoidosis, Osteolytic lesions, Osseous sarcoidosis, Phalanges.
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Burylova, E. A., L. A. Mamaeva, A. S. Berdnikova, and O. K. Fedorova. "Orbital lesion (pseudotumor and dacryoadenitis) is a manifestation of systemic sarcoidosis." Russian Journal of Clinical Ophthalmology 21, no. 1 (2021): 40–44. http://dx.doi.org/10.32364/2311-7729-2021-21-1-40-44.
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Ocular manifestations of systemic sarcoidosis may emerge at any disease stage. Ocular sarcoidosis is typically characterized by uveitic presentations that predominantly involve the choroid of anterior eye segment. However, orbital pseudotumor, dacryoadenitis, and other rare presentations (optic neuritis, dacryocystitis etc.) also occur in sarcoidosis. Threatened vision loss and poor quality of life are the reasons to prescribe systemic steroids in generalized sarcoidosis. Chest CT is required to identify respiratory diseases when sarcoidosis manifests as uveitis or granulomatous orbital inflammation. Multidisciplinary diagnostic and treatment approach to suspected sarcoidosis provides timely verified diagnosis and management strategy. This paper addresses case report of systemic sarcoidosis in a 34-year-old man. The initial manifestation was vision loss and left orbital pseudotumor. The enlarged subclavian lymph node and its biopsy were suspicious of granulomatous inflammation. Chest CT identified disseminated pulmonary lesions and intrathoracic lymphadenopathy that are typical of sarcoidosis. The results of multidisciplinary examinations verified systemic sarcoidosis. Systemic steroids resulted in clinical and radiological improvement and medicinal regression of the disease. Keywords: sarcoidosis, orbital pseudotumor, dacryoadenitis, adenopathy, computed tomography, multidisciplinary approach. For citation: Burylova E.A., Mamaeva L.A., Berdnikova A.S., Fedorova O.K. Orbital lesion (pseudotumor and dacryoadenitis) is a manifestation of systemic sarcoidosis. Russian Journal of Clinical Ophthalmology. 2021;21(1):40–44. DOI: 10.32364/2311-7729-2021-21-1-40-44.
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Richard, Mael, Yvan Jamilloux, Pierre-Yves Courand, Laurent Perard, Cécile-Audrey Durel, Arnaud Hot, Carole Burillon, et al. "Cardiac Sarcoidosis Is Uncommon in Patients with Isolated Sarcoid Uveitis: Outcome of 294 Cases." Journal of Clinical Medicine 10, no. 10 (May 15, 2021): 2146. http://dx.doi.org/10.3390/jcm10102146.
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Recently, concerns have been raised about an increased risk of cardiac sarcoidosis in patients with sarcoid uveitis. While cardiac sarcoidosis has a high mortality burden, there is still a lack of precise data on this association. The objective of this study is to describe the frequency and type of cardiac complications associated with sarcoidosis of a large cohort of patients with sarcoid uveitis. We analyzed the cardiac outcomes of a monocentric retrospective cohort of consecutive adults with a diagnosis of sarcoid uveitis between January 2004 and March 2020 in a tertiary French university hospital. A total of 294 patients with a final diagnosis of sarcoid uveitis were included. At final follow-up, seven (2.4%) patients of the cohort had cardiac sarcoidosis. Cardiac sarcoidosis was more frequent among patients with previously reported systemic sarcoidosis (p = 0.008). The prevalence of cardiac sarcoidosis among patients with sarcoid uveitis is low, but patients with previously diagnosed sarcoidosis or those who develop systemic sarcoidosis during follow-up appear to be at increased risk.
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Sweidan, Alexander J., Navneet K. Singh, Alexander Stein, and Maged Tanios. "Nodular Sarcoidosis Masquerading as Cancer." Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine 11 (January 1, 2017): 117954841770312. http://dx.doi.org/10.1177/1179548417703123.
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Nodular lung disease is a rare pulmonary manifestation of sarcoidosis and resembles metastatic neoplasm disease. Nodular sarcoidosis is rare, varying from 1.6% to 4% of patients with sarcoidosis. Radiographic nodules measure from 1 to 5 cm in diameter that typically consist of coalescent granulomas. There is limited data on this form of sarcoidosis and its presentation can mimic primary or metastatic pulmonary neoplasms. Nodular sarcoidosis has a favorable prognosis, and resolution can be seen with oral corticosteroids. Herein, we present such a case of nodular pulmonary sarcoidosis with a lung nodule measured up to 6 cm.
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Arkema, Elizabeth V., and Yvette C. Cozier. "Epidemiology of sarcoidosis: current findings and future directions." Therapeutic Advances in Chronic Disease 9, no. 11 (August 24, 2018): 227–40. http://dx.doi.org/10.1177/2040622318790197.
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Sarcoidosis is a granulomatous inflammatory disease with unknown etiology. Epidemiological studies have contributed greatly to our knowledge about sarcoidosis, providing critical information on the determinants and distribution of the disease. In this review, we summarize recently published findings from epidemiological studies on sarcoidosis. We review the epidemiological tools used, the incidence and prevalence of disease, mortality and cancer risk after sarcoidosis and nongenetic risk factors for sarcoidosis. Genetics studies have not been included as they deserve a separate review. Leveraging existing epidemiological data to conduct etiological studies aimed towards understanding and preventing disease is critical for future sarcoidosis research.
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Kiani, Arda, Atefeh Abedini, Ian M. Adcock, Maryam Sadat Mirenayat, Kimia Taghavi, Esmaeil Mortaz, and Mehdi Kazempour-Dizaji. "Association Between Vitamin D Deficiencies in Sarcoidosis with Disease Activity, Course of Disease and Stages of Lung Involvements." Journal of Medical Biochemistry 37, no. 2 (April 1, 2018): 103–9. http://dx.doi.org/10.1515/jomb-2017-0041.
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SummaryBackground:Despite negative association between 25-hydroxy vitamin D and incidence of many chronic respiratory diseases, this feature was not well studied in sarcoidosis. Current study investigated the association between 25-hydroxy vitamin D deficiency with sarcoidosis chronicity, disease activity, extra-pulmonary skin manifestations, urine calcium level and pulmonary function status in Iranian sarcoidosis patients. Results of this study along with future studies, will supply more effective programs for sarcoidosis treatment.Methods:Eighty sarcoidosis patients in two groups of insufficient serum level and sufficient serum level of 25-hydroxy vitamin D were studied. Course of sarcoidosis was defined as acute and chronic sarcoidosis. Pulmonary function test (PFT) was assessed by spirometry. Skin involvements were defined as biopsy proven skin sarcoidosis. 24-hour urine calcium level was used to specify the disease activity. Stages of lung involvements were obtained by CT-scan and chest X-ray. The statistical analyses were evaluated using Statistical Package for the Social Sciences.Results:A significant negative correlation was obtained between vitamin D deficiency in sarcoidosis patients and disease chronic course and stages two to four of lung involvements. Considering other parameters of the disease and vitamin D deficiency, no significant correlation was detected.Conclusions:In conclusion, results of the current study implies in the role of vitamin 25(OH)D deficiencies in predicting the course of chronic sarcoidosis. Furthermore, it was concluded that vitamin 25(OH)D deficiency can direct pulmonary sarcoidosis toward stage 2–4 of lung involvements.
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Li, Cheng-Wei, Ru-Jia Tao, Dan-Feng Zou, Man-Hui Li, Xin Xu, and Wei-Jun Cao. "Pulmonary sarcoidosis with and without extrapulmonary involvement: a cross-sectional and observational study in China." BMJ Open 8, no. 2 (February 2018): e018865. http://dx.doi.org/10.1136/bmjopen-2017-018865.
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ObjectivesSarcoidosis is a multisystem disease characterised by the formation of granulomas within various organs, mainly the lungs. Several studies from different countries have been undertaken to investigate sarcoidosis with extrapulmonary involvement except from China. The objective of this study is to investigate a comparative clinical analysis in patients with pulmonary sarcoidosis with and without extrapulmonary involvement from China.MethodsData from inpatients diagnosed with sarcoidosis at Shanghai Pulmonary Hospital (Shanghai, China) between January 2009 and December 2014 were retrospectively collected and analysed. Six hundred and thirty-six patients with biopsy-proven sarcoidosis were included in the study, including 378 isolated pulmonary sarcoidosis and 258 pulmonary sarcoidosis plus extrapulmonary involvement.ResultsTwo hundred and fifty-eight (40.6%) patients with pulmonary sarcoidosis had extrapulmonary involvement. Extrapulmonary localisations were detected mostly in extrathoracic lymph nodes (n=147) and skin (n=86). Statistically significant differences were demonstrated between patients with pulmonary sarcoidosis plus extrapulmonary involvement and patients with isolated pulmonary sarcoidosis for fatigue (16.6%vs8.3%, P<0.05), serum ACE (SACE) levels (79.0±46.9 IU/L vs 69.7±38.7 IU/L, P<0.05), and high-resolution CT (HRCT) findings (53.8%vs46.2%, P<0.05).ConclusionsExtrapulmonary involvement is common in patients with pulmonary sarcoidosis, with the most common sites being extrathoracic lymph nodes and skin. Patients with sarcoidosis with extrapulmonary involvement are more symptomatic (fatigue), have higher SACE levels and more deteriorating HRCT findings, to which clinicians should pay attention.
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Niewiadomska, Ewa, Małgorzata Kowalska, and Michał Skrzypek. "Diseases Coexisting with Sarcoidosis and Cost of their Treatment in Silesian Voivodeship (Poland)." Open Public Health Journal 14, no. 1 (April 19, 2021): 174–80. http://dx.doi.org/10.2174/1874944502114010174.
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Objectives: Sarcoidosis is a complex systemic disease with many symptoms of unknown etiology. The chronic course of sarcoidosis often allows it to co-occur with other diseases. A coexisting different form of sarcoidosis in some studies and no data regarding the costs of treatment justify the aim of the study. This study aims to assess a different form of sarcoidosis because no current data exist regarding the cost of this treatment. Methods: The epidemiological and economic analysis focused on diseases coexisting with sarcoidosis in the adult population of the Silesian Voivodeship (Poland), from 2011 to 2015, was conducted based on the secondary epidemiological data. The study involved 2,922 cases of the primary diagnosis of sarcoidosis (code D86 according to ICD-10) and 505 cases of sarcoidosis coexisting with another. Results: One out of ten patients with sarcoidosis has been found to be diagnosed with at least one comorbid disease. The comorbid disease includes diseases of the circulatory and respiratory system as well as endocrine, neoplasms, nutritional and metabolic diseases. The average unit cost of sarcoidosis therapy increases with the number of comorbidities and depends on the nature of the primary diagnosis and type of medical service. Conclusion: The epidemiological situation of diseases coexisting with sarcoidosis has been found to be similar to those reported in other European countries. However, neoplasms are one of the most common frequent comorbidities in Poland. The results obtained confirmed the strong impact of comorbidities on the cost of treatment of sarcoidosis.
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Noiles, Kristin, Katie Beleznay, Richard I. Crawford, and Sheila Au. "Sarcoidosis Can Present with Necrotizing Granulomas Histologically: Two Cases of Ulcerated Sarcoidosis and Review of the Literature." Journal of Cutaneous Medicine and Surgery 17, no. 6 (November 2013): 377–83. http://dx.doi.org/10.2310/7750.2013.13035.
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Background: Sarcoidosis is a systemic inflammatory disorder with cutaneous involvement present in 25% of cases. The presence of naked granulomas histologically is the hallmark of sarcoidosis. The presence of necrotizing granulomas is highly suggestive of other granulomatous conditions and leads the clinician to pursue other diagnoses, such as infectious causes. Objectives: We describe two cases of sarcoidosis in which necrotizing granulomas were present on biopsy. Both patients had ulcerated cutaneous lesions of sarcoidosis. In one case, the presence of these atypical histologic features led to a delay in diagnosis of almost 10 years. We review the various histopathologic findings associated with cutaneous sarcoidosis and discuss a potential connection between ulcerated sarcoidosis and atypical histologic findings. Conclusion: When atypical histopathologic features are present, the differential diagnosis of sarcoidosis should not be excluded.
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Judson, Marc A. "Developing better drugs for pulmonary sarcoidosis: determining indications for treatment and endpoints to assess therapy based on patient and clinician concerns." F1000Research 8 (December 30, 2019): 2149. http://dx.doi.org/10.12688/f1000research.20696.1.
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Pulmonary sarcoidosis involves the deposition of granulomas within the lung. These granulomas may affect lung function and lead to pulmonary symptoms, pulmonary dysfunction, functional impairment, and worsening of quality of life. Corticosteroids are generally highly effective in resolving the granulomatous inflammation of sarcoidosis. However, despite the effectiveness of corticosteroids, many corticosteroid-responsive patients continue to experience significant problems because of the development of fibrosis from previously active or active smoldering granulomatous inflammation, inflammatory effects from sarcoidosis unrelated to granuloma deposition in lung tissue (parasarcoidosis syndromes), and the development of significant corticosteroid-related side effects. For these reasons, the decision to treat pulmonary sarcoidosis and endpoints to measure meaningful outcomes may extend beyond considerations of pulmonary granulomatous inflammation alone. In this article, we propose a conceptual framework to describe the mechanisms by which pulmonary sarcoidosis significantly impacts patients. This conceptual framework suggests that indications for the treatment of pulmonary sarcoidosis and endpoints to assess treatment depend on the specific mechanisms that are causing functional or quality-of-life impairment (or both) in patients with pulmonary sarcoidosis. We believe that these concepts are important to clinicians treating pulmonary sarcoidosis and to clinical researchers designing pulmonary sarcoidosis trials.
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Marak, Creticus P., Narendrakumar Alappan, Amit Chopra, Olena Dorokhova, Sumita Sinha, and Achuta K. Guddati. "Uterine Sarcoidosis: A Rare Extrapulmonary Site of Sarcoidosis." Case Reports in Rheumatology 2013 (2013): 1–5. http://dx.doi.org/10.1155/2013/706738.
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Sarcoidosis is a multisystem disease which is most commonly manifested in the pulmonary system. However, extrapulmonary manifestations have also been frequently reported. Isolated occurrence of sarcoidosis in the genital system is rare and poses a diagnostic and therapeutic dilemma. Uterine sarcoidosis can present with cervical erosions, endometrial polypoid lesions, and recurrent serometra. In majority of cases, it is diagnosed by endometrial curettage, but it has also been detected by examination of hysterectomy, polypectomy, and autopsy specimens. Nonnecrotizing granulomas are the characteristic pathologic finding of sarcoidosis. However, many infectious and noninfectious etiologies including certain neoplasms can produce similar granulomatous reactions in the female genital tract. These conditions affect the female genital tract more commonly than sarcoidosis, and therefore it is important to rule out these conditions first before making a diagnosis of sarcoidosis. Treatment of sarcoidosis is different from treating these other conditions and the most commonly used systemic or local corticosteroids can be hazardous if the underlying cause is infection. In this case report, the clinical presentation, histopathology, clinical course, and treatment of a patient with isolated uterine sarcoidosis are described, and a brief literature review of sarcoidosis of the female genital tract is provided.
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Andrea Jennings. "Awareness of pulmonary sarcoidosis in the older adult: A case study approach." World Journal of Advanced Research and Reviews 11, no. 1 (July 30, 2021): 212–14. http://dx.doi.org/10.30574/wjarr.2021.11.1.0346.
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The purpose of this case study is to highlight sarcoidosis as a disease with complexities and one that requires a multidisciplinary team approach. A case study profiling an older adult who has been diagnosed with pulmonary sarcoidosis is discussed. Providing education about sarcoidosis is key for all patients. Nurses play an important role in educating patients with sarcoidosis in both inpatient and outpatient healthcare settings. Education, self-advocacy, and family support are all vital in the management of sarcoidosis.
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Bhatti, Prashan, Michael Waight, Daniel Bromage, and Daniel Sado. "Cardiac sarcoidosis in a patient with testicular seminoma." BMJ Case Reports 12, no. 9 (September 2019): e229912. http://dx.doi.org/10.1136/bcr-2019-229912.
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Sarcoidosis is a multisystem disorder characterised by non-caseating granulomas that typically affect the lungs, skin and lymph nodes. Sarcoidosis has been associated with various cancers, and we describe the case of a patient with systemic sarcoidosis associated with testicular seminoma. This was originally diagnosed as stable sarcoid-like reaction. He subsequently presented with ventricular tachycardia. Cardiovascular MRI suggested cardiac sarcoidosis, which was confirmed by myocardial biopsy. This case highlights the association between some types of cancer and sarcoidosis. In addition, it highlights the importance of close follow-up for patients with a history of malignancy to monitor for sarcoid-like reactions and sarcoidosis, which are often difficult to differentiate clinically.
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El Achi, Hanadi, William Glass, Miriam Velazquez, and Zhihong Hu. "A 62-Year-Old African American Woman With Stable Lymphadenopathy Over 5 Years." American Journal of Clinical Pathology 152, Supplement_1 (September 11, 2019): S110. http://dx.doi.org/10.1093/ajcp/aqz121.014.
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Abstract The patient is a 62-year-old African American female with medical history of Plummer Vinson syndrome and CT scan in 2014 showing lymphadenopathy of the porta hepatis. Needle core biopsy of enlarged lymph nodes revealed sheets of polytypic plasma cells with no aberrant B or T cells or granulomas or hyaline-like depositions identified. The findings were suspicious for unicentric Castleman disease. In 2019, the patient presented with chronic fatigue without other systemic symptoms. Contrast CT revealed persistent retroperitoneal lymphadenopathy and calcified granulomas in the liver, spleen, and lung. Excision of portal and celiac nodes showed preserved nodal architecture with mild mantle zone expansion and marked hyaline-like deposition in the follicles. Sheets of mature plasma cells and focally increased vasculatures were seen in the interfollicular areas. Focally frequent nonnecrotizing granulomas were noted. Occasional giant cells and rare asteroid bodies were identified in the granulomas. Immunohistochemistry stain workup revealed normal distribution of the B and T lymphocytes. CD138 stain highlighted marked increased plasma cells and HHV8 was negative. Immunofluorescence microscopy for kappa and lambda did not show monoclonality; IgA was positive in <10% of plasma cells; special stain for Congo red and serum amyloid associated protein (SSA) IHC stain were strongly positive in the follicles. The overall findings are consistent with reactive lymphadenopathy with interfollicular polytypic plasmacytosis, noncaseating granuloma formation, and reactive amyloidosis. The features of mantle zone hyperplasia and polytypic plasmacytosis are suggestive of HHV8-negative/idiopathic unicentric Castleman disease. This case possibly represents an example of concurrent amyloidosis, sarcoidosis, and idiopathic unicentric Castleman disease. Given that SSA was recently reported to have a pathogenic role in granulomatous inflammation of sarcoidosis through sustained inflammatory reaction, the possibility of increased SSA triggering sarcoidoisis in this patient can be considered. However, the exact pathogenesis of these concurrent findings needs further investigation and clarification.
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Zaitsev, A. A., A. A. Wiesel, and D. N. Antipushina. "SARCOIDOSIS IN MILITARY PERSONNEL: BASES OF DIAGNOSTICS, TREATMENT AND FOLLOW-UP." Marine Medicine 5, no. 4 (November 29, 2019): 7–14. http://dx.doi.org/10.22328/2413-5747-2019-5-4-7-14.
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Sarcoidosis is an urgent problem for the military medical service of various law enforcement agencies. In recent years, there has been an increase in the incidence of sarcoidosis among young people undergoing military service and the creation of a unified algorithm of medical care for this contingent is important. The publication presents the epidemiology of the disease, known risk factors, and triggers for the development of sarcoidosis in military sailors. The most important factors associated with a high risk of sarcoidosis are: high dustiness of the air, diesel and rocket fuel vapors, and various types of radiation. In military personnel, the second stage of sarcoidosis is most common. The recurrence rate of the disease is 20%, and the factors associated with the recurrent course of sarcoidosis in military personnel are — the age of more than 35 years; the presence of clinical manifestations of sarcoidosis (cough, weakness, shortness of breath); forced lung capacity <85%; a history of systemic glucocorticosteroids. The article presents the recommended algorithm and methods for examining patients with sarcoidosis. It is noted that the main point is the mandatory morphological verification of the process in the military. Special attention is paid to the treatment of sarcoidosis in the publication. It is noted that, given the high frequency of remissions, treatment is not indicated for stage I, as well as for asymptomatic patients with stages II and III of sarcoidosis, provided that only mild disorders of the ventilation and diffusion function of the lungs are present. All patients with sarcoidosis are subject to active medical supervision.
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Zakaria, Ali, Bayan Al Share, Issam Turk, Samira Ahsan, and Waseem Farra. "An Uncommon Cause of a Small-Bowel Obstruction." Case Reports in Gastrointestinal Medicine 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/1628215.
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Sarcoidosis is a systemic granulomatous disease of unknown etiology, characterized by the formation of noncaseating granulomas. Gastrointestinal (GI) system involvement that is clinically recognizable occurs in less than 0.9% of patients with sarcoidosis, with data revealing small intestine involvement in 0.03% of the cases. A high index of suspension is required in patients presenting with small-bowel obstruction and previous history of sarcoidosis. Establishing a definitive diagnosis of GI sarcoidosis depends on biopsy evidence of noncaseating granulomas, exclusion of other causes of granulomatous disease, and evidence of sarcoidosis in at least one other organ system. Treatment of GI sarcoidosis depends on symptomatology and disease activity. Herein, we are presenting a case of 67-year-old female patient who had acute small-bowel obstruction at the level of jejunum with postoperative histopathologic evidence of noncaseating granulomatous inflammation with multinucleated giant cells, consistent with sarcoidosis.
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Entrop, Joshua P., Susanna Kullberg, Johan Grunewald, Anders Eklund, Kerstin Brismar, and Elizabeth V. Arkema. "Type 2 diabetes risk in sarcoidosis patients untreated and treated with corticosteroids." ERJ Open Research 7, no. 2 (April 2021): 00028–2021. http://dx.doi.org/10.1183/23120541.00028-2021.
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BackgroundThe rate of type 2 diabetes mellitus (T2D) is increased in sarcoidosis patients but it is unknown if corticosteroid treatment plays a role. We investigated whether the T2D risk is higher in untreated and corticosteroid-treated sarcoidosis patients compared with the general population.MethodsIn this cohort study, individuals with two or more International Statistical Classification of Diseases and Related Health Problems (ICD) codes for sarcoidosis were identified from the Swedish National Patient Register (NPR) (n=5754). Corticosteroid dispensations within 3 months before or after the first sarcoidosis diagnosis were identified from the Swedish Prescribed Drug Register (PDR). General population comparators without sarcoidosis were matched to cases 10:1 on age, sex and region of residence (n=61 297). Incident T2D was identified using ICD codes (NPR) and antidiabetic drug dispensations (PDR). Follow-up was from the second sarcoidosis diagnosis/matching date until T2D, emigration, death or study end (December 2013). Cox regression models adjusted for age, sex, education, country of birth, healthcare regions and family history of diabetes were used to estimate hazard ratios (HRs). We used flexible parametric models to examine the T2D risk over time.Results40% of sarcoidosis patients were treated with corticosteroid at diagnosis. The T2D rate was 7.7 per 1000 person-years in untreated sarcoidosis, 12.7 per 1000 person-years in corticosteroid-treated sarcoidosis and 5.5 per 1000 person-years in comparators. The HR for T2D was 1.4 (95% CI 1.2–1.8) associated with untreated sarcoidosis and 2.3 (95% CI 2.0–3.0) associated with corticosteroid-treated sarcoidosis. The T2D risk was highest for corticosteroid-treated sarcoidosis in the first 2 years after diagnosis.ConclusionsSarcoidosis is associated with an increased risk of T2D especially in older, male, corticosteroid-treated patients at diagnosis. Screening for T2D for these patients is advisable.
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Ustinova, Elena Ivanovna. "Ocular sarcoidosis." Ophthalmology journal 8, no. 3 (December 15, 2015): 86–94. http://dx.doi.org/10.17816/ov2015386-94.
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The data of national and foreign literature review and personal observations data analysis in patients with ocular sarcoidosis are presented. The emphasis is made on clinical signs and evaluation of the eyeball inner layers involvement: iridocyclitis and chorioretinitis. Main systemic and ophthalmic symptoms of the disease are described. Sarcoidosis epidemiology and etiology are also covered. Main traditional and modern therapeutical approaches in sarcoidosis including peculiarities of ocular sarcoidosis treatment are discussed in detail. International sarcoidosis treatment guidelines as well as treatment results and outcomes are presented.
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Skodric-Trifunovic, Vesna, Violeta Vucinic, Radoje Colovic, Jelica Videnovic-Ivanov, Vladimir Zugic, and Jelena Stojsic. "Liver and splenic sarcoidosis: Diagnostic procedures." Medical review 57, no. 9-10 (2004): 462–66. http://dx.doi.org/10.2298/mpns0410462s.
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Introduction Clinical studies indicate involvement of the liver and spleen in approximately 20-30% of patients affected with sarcoidosis and their detection should be based on a standardized diagnostic procedure. Diagnostic procedures Ultrasonography is a reliable and safe method to assess changes related to size and structure of the affected organs that are pathognomonic for sarcoidosis. Further evaluation may include computerized tomography or magnetic resonance, while percutaneous needle aspiration biopsy or laparoscopy may also be applied when indicated. The most important criterion used for final diagnosis is pathohistological evidence of epithelioid noncaseating granuloma in bioptic material along with already established sarcoidosis of the lungs or some other organ. Material and methods The study on the incidence of liver and spleen sarcoidosis included a group of 130 patients affected with sarcoidosis hospitalized at the Institute of Pulmonary Diseases and Tuberculosis, Clinical Center of Serbia, over the period 2002-2003. Results The analysis evidenced that 31.5% of sarcoidosis patients had pathognomonic echographic findings of abdominal organs: splenomegaly (13%), hepatomegaly (10.8%) and hepatosplenomegaly (7.7%). Three patients underwent surgical treatment of liver and spleen sarcoidosis. Conclusion Pathognomonic findings of liver and spleen sarcoidosis were evidenced in approximately one third of sarcoidosis cases and they represented a significant parameter for further therapy, particularly in chronic patients.
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Tiago Serra, Joao, Aurelia Martinho, Fernanda Paixao Duarte, and Fernando Aldomiro. "Sarcoidosis and Multiple Myeloma: A Case Report and Literature Review." Case Reports in Hematology 2019 (October 30, 2019): 1–5. http://dx.doi.org/10.1155/2019/4586265.
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The existence of a sarcoidosis-lymphoma syndrome has been previously proposed since the relation between sarcoidosis and an increased risk of lymphoproliferative disorders is well established. Multiple myeloma is a malignant multifocal proliferation of clonal plasma cells within the bone marrow, and its association with sarcoidosis has been rarely described. We present a concurrent diagnosis of sarcoidosis and multiple myeloma and make a brief analysis of the reported cases in the literature. A 65-year-old woman underwent surgery for the excision of a wrist mass that presented 3 years before. Histological analysis showed sarcoid-type epithelioid granulomas without necrosis, establishing soft tissue sarcoidosis. Further evaluation revealed marked interstitial lung parenchyma lesions and large intrathoracic adenopathies. Bronchofibroscopy with transbronchial biopsy confirmed lung sarcoidosis. In addition, blood analysis showed monoclonal IgG kappa gammopathy. A bone marrow biopsy confirmed hypercellularity with 60% plasma cells and plasmocyte infiltration. Thus, the diagnosis of systemic sarcoidosis and multiple myeloma was established simultaneously. In a brief review of the literature, we identified 33 reports of cases with both sarcoidosis and multiple myeloma. We point out the importance of a high level of suspicion for the association of sarcoidosis with malignant haematological diseases such as multiple myeloma.
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Groen-Hakan, Fahriye, Laura Eurelings, Aniki Rothova, and Jan van Laar. "Lymphopaenia as a predictor of sarcoidosis in patients with a first episode of uveitis." British Journal of Ophthalmology 103, no. 9 (November 15, 2018): 1296–300. http://dx.doi.org/10.1136/bjophthalmol-2018-313212.
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Background/aimsThe diagnostic properties of conventional diagnostic tests (ACE and chest radiography) for sarcoidosis-associated uveitis are not ideal. The diagnostic value of lymphopaenia for sarcoidosis-associated uveitis is investigated.MethodsA retrospective study of 191 consecutive patients with a first uveitis episode visiting the ophthalmology department (Erasmus Medical Center, Rotterdam, The Netherlands). Receiver operating characteristics (ROC) analysis was performed and compared with known ROC values from literature of conventional diagnostic tests for sarcoidosis-associated uveitis. An ideal cut-off was determined for lymphopaenia by calculation of the highest Youden index.ResultsOut of all patients with first uveitis attack, 32/191 or 17% were subsequently diagnosed with biopsy-proven or radiological diagnosis of sarcoidosis. Lymphopaenia (<1.5×109/L) was significantly more often observed in patients with sarcoidosis-associated uveitis compared with patients with non-sarcoidosis-associated uveitis (p<0.05). The sensitivity and specificity of lymphopaenia was 75 % and 77 %, respectively. The optimal cut-off for lymphopaenia for diagnosing sarcoidosis-associated uveitis was 1.47 ×109/L. Lymphopaenia resulted in a 12.0 (95% CI 4.7 to 30.5 fold risk for having sarcoidosis, corrected for sex, race and age at onset of uveitis in patients with a first uveitis attack.ConclusionLymphopaenia is a non-invasive and useful marker for diagnosing sarcoidosis-associated uveitis.
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Zimmermann, Alexandra, Henrik Knecht, Robert Häsler, Gernot Zissel, Karoline I. Gaede, Sylvia Hofmann, Almut Nebel, Joachim Müller-Quernheim, Stefan Schreiber, and Annegret Fischer. "Atopobium and Fusobacterium as novel candidates for sarcoidosis-associated microbiota." European Respiratory Journal 50, no. 6 (December 2017): 1600746. http://dx.doi.org/10.1183/13993003.00746-2016.
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Sarcoidosis is a granulomatous disease that mainly affects the lung. A role of microbial factors in disease pathogenesis is assumed, but has not been investigated systematically in a large cohort.This cross-sectional study compared the lung microbiota of 71 patients with sarcoidosis, 15 patients with idiopathic pulmonary fibrosis (non-infectious controls) and 10 healthy controls (HCs). Next-generation sequencing of 16S DNA was used on bronchoalveolar lavage samples to characterise the microbial composition, which was analysed for diversity and indicator species. Host genotypes for 13 known sarcoidosis risk variants were determined and correlated with microbial parameters.The microbial composition differed significantly between sarcoidosis and HC samples (redundancy analysis ANOVA, p=0.025) and between radiographic Scadding types. Atopobium spp. was detected in 68% of sarcoidosis samples, but not in HC samples. Fusobacterium spp. was significantly more abundant in sarcoidosis samples compared with those from HCs. Mycobacteria were found in two of 71 sarcoidosis samples. Host-genotype analysis revealed an association of the rs2076530 (BTNL2) risk allele with a decrease in bacterial burden (p=0.002).Our results indicate Scadding type-dependent microbiota in sarcoidosis BAL samples. Atopobium spp. and Fusobacterium spp. were identified as sarcoidosis-associated bacteria, which may enable new insights into the pathogenesis and treatment of the disease.
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Beijer, Els, Claudia Roodenburg-Benschop, Milou C. Schimmelpennink, Jan C. Grutters, Bob Meek, and Marcel Veltkamp. "Elevated Serum Amyloid a Levels Are not Specific for Sarcoidosis but Associate with a Fibrotic Pulmonary Phenotype." Cells 10, no. 3 (March 7, 2021): 585. http://dx.doi.org/10.3390/cells10030585.
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Elevated Serum Amyloid A (SAA) levels have been found in several inflammatory diseases, including sarcoidosis. SAA is suggested to be involved in sarcoidosis pathogenesis by involvement in granuloma formation and maintenance. We hypothesized that SAA serum levels would be higher in sarcoidosis compared to other non-infectious granulomatous and non-granulomatous diseases. SAA levels were measured in serum from sarcoidosis, Hypersensitivity pneumonitis (HP), and (eosinophilic) granulomatosis with polyangiitis ((E)GPA) patients. Idiopathic pulmonary fibrosis (IPF) patients were included as non-granulomatous disease group. SAA levels of patients with sarcoidosis (31.0 µg/mL), HP (23.4 µg/mL), (E)GPA (36.9 µg/mL), and IPF (22.1 µg/mL) were all higher than SAA levels of healthy controls (10.1 µg/mL). SAA levels did not differ between the diagnostic groups. When SAA serum levels were analyzed in sarcoidosis subgroups, fibrotic sarcoidosis patients showed higher SAA levels than sarcoidosis patients without fibrosis (47.8 µg/mL vs. 29.4 µg/mL, p = 0.005). To conclude, the observation that fibrotic sarcoidosis patients have higher SAA levels, together with our finding that SAA levels were also increased in IPF patients, suggests that SAA may next to granulomatous processes also reflect the process of fibrogenesis. Further studies should clarify the exact role of SAA in fibrosis and the underlying mechanisms involved.
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Janssen, Ulf, Shirin Naderi, and Kerstin Amann. "Idiopathic granulomatous interstitial nephritis and isolated renal sarcoidosis: Two diagnoses of exclusion." SAGE Open Medicine 9 (January 2021): 205031212110384. http://dx.doi.org/10.1177/20503121211038470.
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Granulomatous interstitial nephritis is a rare finding in renal biopsy caused by drugs, infections, and inflammatory or autoimmune diseases. Idiopathic cases account for 18% of granulomatous interstitial nephritis in native kidneys. Sarcoidosis and drugs are the most common causes of granulomatous interstitial nephritis in Western countries, while in India tuberculosis prevails. Few cases of renal sarcoidosis without extrarenal involvement, that is, isolated renal sarcoidosis, have been reported. The diagnostic criteria of isolated renal sarcoidosis remain, however, unclear. Extrarenal sarcoidosis and other etiologies of granulomatous interstitial nephritis, in particular drug-related, have to be excluded. Some of these patients may develop extrarenal manifestations during follow-up. Changes in calcium and vitamin D metabolism are frequently observed in renal sarcoidosis and support its diagnosis. While non-necrotizing granulomas are a feature of sarcoidosis and drug-induced granulomatous interstitial nephritis, they also prevail in tuberculosis-associated granulomatous interstitial nephritis. Granulomatous interstitial nephritis caused by sarcoidosis and drugs usually responds to steroid therapy. A poor response to steroids may indicate an infectious etiology such as tuberculosis and should lead to a review of the initial diagnosis. This article gives an overview of the various etiologies of granulomatous interstitial nephritis, their frequency and histopathological characteristics, as well as potential biomarkers associated with renal sarcoidosis.
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Jovanovic, Dragana, Violeta Vucinic, Ruza Stevic, Marina Roksandic-Milenkovic, Natalija Samardzic, Marta Velinovic, and Mihailo Stjepanovic. "Sarcoidosis of the pleura: A case report." Vojnosanitetski pregled 71, no. 5 (2014): 506–9. http://dx.doi.org/10.2298/vsp1405506j.
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Introduction. Pleural involvement is an uncommon manifestation of sarcoidosis. It may manifest as pleural effusion, pneumothorax, pleural thickening and nodules, hydropneumothorax, trapped lung, hemothorax, or chylothorax. The incidence of pleural effusion with sarcoidosis ranges from 0% to 5% but has been reported to be as high as 7.5%. Pleural effusions complicate sarcoidosis in < 3% of patients. Case report. We reported a 64-year-old male patient with chronic multiorgan sarcoidosis. This patient developed pleural sarcoidosis with massive pleural effusion several years after the diagnosis of sarcoidosis. A definitive diagnosis of a sarcoid pleural effusion was based on a biopsy demonstrating noncaseating granuloma. The patient responded well to the treatment (methotrexate and methylprednisolone) with a complete withdrawal of pleural effusion following five weeks of the treatment beginning. Conclusion. The presented patient is a rare case of pleural involvement of sarcoidosis with massive effusion, who responded well to the treatment.
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Kasikovic-Lecic, Svetlana, Violeta Vucinic, Milana Panjkovic, and Biljana Kukic. "Gastric sarcoidosis." Srpski arhiv za celokupno lekarstvo 145, no. 3-4 (2017): 195–98. http://dx.doi.org/10.2298/sarh160303048k.
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Introduction. Sarcoidosis is a systemic disease with a 90% predilection for the lungs, but any organ can be involved. Gastric sarcoidosis may be a component of a generalized process, while isolated gastric sarcoidosis is very rare. Case Outline. We describe a rare case of biopsy-proven gastric sarcoidosis in a 45-year-old woman with pulmonary sarcoidosis in remission, and highlight the importance of gastroscopy and biopsy to confirm the diagnosis. Her optimal response to anti-acid therapy required no alternate (glucocorticoid) therapy. We briefly review the clinical, diagnostic, and therapeutic aspects of gastric sarcoidosis. Conclusion. Glucocorticoids remain the cornerstone of the sarcoidosis treatment, although it has been insufficiently documented by clinical trials. The decision to treat sarcoid patients with systemic glucocorticoids is largely based upon the severity of symptoms. The anti-acid therapy may be an alternative in milder cases, as demonstrated in our patient.