Osseous sarcoidosis: A multicenter retrospective case-control study of 48 patients
| Autor: | Catherine Chapelon-Abric, Marc Scherlinger, B. Meunier, Matthieu Groh, David Saadoun, Noémie Chanson, Nathalie Saidenberg-Kermanac’h, Karim Sacre, Camille Glanowski, Nicolas Schleinitz, Patrice Cacoub, Cloé Comarmond, Sandrine Hirschi, Imen Ben Hassine, Hervé Devilliers, Christophe Richez, Christopher Rein, Laurent Arnaud, Philip Bielefeld |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male musculoskeletal diseases medicine.medical_specialty Sarcoidosis Caseous necrosis Risk Assessment Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Rheumatology Humans Medicine Femur 030212 general & internal medicine Glucocorticoids Lymph node Pelvis Retrospective Studies 030203 arthritis & rheumatology business.industry Biopsy Needle Hydroxychloroquine Middle Aged Prognosis musculoskeletal system medicine.disease Immunohistochemistry Magnetic Resonance Imaging 3. Good health stomatognathic diseases Methotrexate Treatment Outcome medicine.anatomical_structure Case-Control Studies Granuloma Drug Therapy Combination Female France Lymph Nodes Radiology Bone Diseases business medicine.drug |
| Zdroj: | Joint Bone Spine. 86:789-793 |
| ISSN: | 1297-319X |
| DOI: | 10.1016/j.jbspin.2019.07.009 |
| Popis: | To describe the clinical presentation, distribution of lesions, treatment, and outcomes of osseous sarcoidosis.A French retrospective multicenter study of patients with biopsy-proven sarcoidosis analyzed patients with 1) a biopsy-proven granuloma without caseous necrosis, and either 2) osseous clinical manifestations, or 3) abnormal osseous imaging. Sarcoidosis patients with osseous involvement (cases) were compared with 264 age- and sex-matched sarcoidosis patients with no osseous manifestations (controls).In the osseous sarcoidosis group (n=88), forty-two (48%) patients had osseous-related symptoms involving the axial (69%) and/or appendicular (58%) skeleton. On imaging, the most commonly affected bones were in the spine (52%), pelvis (42%), hands (22%) and femur (19%). Compared with controls, cases had higher rates of mediastinal (93% vs. 47%) and extra-thoracic lymph node involvement (66% vs. 21%), pulmonary (90% vs. 65%) and cutaneous involvement (44% vs. 23%) (all P0.0001), and hypercalcemia (8.5% vs. 2%, P=0.014). Spleen/liver and gastrointestinal involvement were less frequent in the osseous sarcoidosis group (29% vs. 45%, and 1% vs. 17%, respectively, P0.0001). Response rates to with glucocorticoids alone, glucocorticoids plus methotrexate or glucocorticoids plus hydroxychloroquine were 23/44 (52%), 9/13 (69%) and 4/6 (67%), respectively.In patients with osseous sarcoidosis the spine and pelvis were the most commonly affected bones. Compared with controls, cases with osseous sarcoidosis have higher rates of thoracic and extra-thoracic lymph node involvement, pulmonary and cutaneous involvement, and hypercalcemia. Most patients with osseous sarcoidosis had a good response to glucocorticoids in combination with methotrexate or hydroxychloroquine. |
| Databáze: | OpenAIRE |
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