Rhumatologic disorders of Sarcoïdosis

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Published Oct 27, 2010
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Vol. 88 No. 11 (2010): Issue Nov 2010

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Wafa Hamdi
Olfa Néji
Mohamed Mehdi Ghannouchi
Dhia Kaffel
Mohamed Montacer Kchir

Abstract

Sarcoidosis is a systemic granulomatous disease of unknown etiology. It has various clinical features. The most commonly affected organs are the lung, the lymph nodes, the eyes and the skin.
Involvement of the musculoskeletal system is far less common and may be inaugural. Articular involvement is dominated by Lofgren syndrome and acute polyarthritis. Abarticular manifestations are often confounded with arthritis. Bone locations are dominated by sarcoidosis dactylitis and osteolysis. Muscular involvement is often unknown and can appear as 3 clinical features: spread form, myositique form or pseudotumoral form. Calcium balance disturbances are dominated by hypercalcemia which is often asymptomatique, but sometimes it reveal the sarcoidosis. Treatment of rheumatologic disorders often involves non steroidal antiinflammatory drugs, corticosteroids and methotrexate. Biological therapies such as the anti-TNFa and the anti-CD20 were showed to be effective in some case reports of severe and refractory disease.

Keywords:

Sarcoïdosis, polyarthritis, dactylitis, osteolysis, myositis, hypercalcemia

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References

  1. Valeyre D, Nunes H, Duperron F, Soler P, Kambouchner M, Brauner M. Sarcoïdose. EMC-Pneumologie 2005;2:147-64.
  2. Chaouat Y, Benichou C. La maladie de Perthes-Jungling. Gaz Med Fr 1964;71:1125-30.
  3. Lofgren S. Age distribution of erythema nodosum. Acta Med Scand. 1950;136 :241-9.
  4. Handa T, Nagai S, Ito I et al. Multiple bone fractures found in a young sarcoidosis patient with long stable disease. Intern Med 2005;44:1269-75.
  5. Imai S, Matsusue Y. Recurrent solitary sarcoidosis in bone - a case report. Acta Orthop Scand 2003;74:626-8.
  6. Neville E, Carstairs S, Geraint James D. Sarcoidosis of bone. Q J Med 1977;46:215-27.
  7. Alaoui FZ, Talaoui M, Benamour S. Manifestations ostéoarticulaires de la sarcoïdose. Presse Med 2005;34:19-24.
  8. Karkowski L, Carassou P, Debourdeau P, Crevon L, Pavic M. Une ostéolyse des doigts. Rev Med Interne 2008;29:63-4..
  9. Sartoris DJ, Resnick D, Resnick C, Yaghmai I. Musculoskeletal manifestations of sarcoidosis. Semin Roentgenol 1985;20:376-86.
  10. Mathur A, Kremer JM. Immunopathology, rheumatic features and therapy of sarcoidosis. Curr Opin Rheumatol 1992;4:76-80.
  11. Allanore Y, Perrot S, Menkès CJ, Kahan A. Traitement d'une atteinte osseuse sarcoïdosique bifocale associant calcanéite et dactylite. Rev Rhum 2001;68:273-6.
  12. Santiago MB, Lima I, Feitosa AC, Braz Ade S, Miranda LG. Pseudoclubbing is it different from clubbing? Semin Arthritis Rheum 2009;38:452-7.
  13. Torralba KD, Quismorio FP Jr. Sarcoidosis arthritis: a review of clinical features, pathology and therapy. Sarcoidosis Vasc Diffuse Lung Dis 2003;20:95-103.
  14. Schwartzbauer HR, Tami TA. Ear, nose, and throat manifestations of sarcoidosis. Otolaryngol Clin North Am. 2003 ;36:673-84.
  15. Bouvier M, Lejeune E, Queneau P, Ryon M. Sarcoïdose avec lacunes crâniennes. Rev Rhum 1972;39:205-14.
  16. Thuong M, Louvet Ch, Bondeville JM et al. Atteinte osseuse du calcanéum au cours de la sarcoïdose. A propos d'un cas. Rev Med Interne 1992;13:378-80.
  17. Goobar IE, Gilmer WS, Caroll S et al. Vertebral sarcoidosis. JAMA 1961;178:1162-3.
  18. Zener JC, Alpert M, Klainer LM. Vertebral sarcoidosis. Arch Intern Med 1963;111:696-712.
  19. Clarençon F, Silbermann-Hoffman O, Lebreton C et al. Diffuse spine involvement in sarcoidosis with sternal lytic lesions: two case reports. Spine 2007;32:E594-7.
  20. Mangino D, Stover DE. Sarcoidosis Presenting as Metastatic Bony Disease. A Case Report and Review of the Literature on Vertebral Body Sarcoidosis. Respiration 2004;71:292-4.
  21. Nijjar SS, Leslie WD. A case of skeletal sarcoidosis imitating skeletal metastases on bone scintigraphy. CMAJ (Canadian Medical Association Journal ) 2008;178:153-4.
  22. Koïke H, Misu K, Yasui K and al. Differential response to corticosteroid therapy of MRI findings and clinical manifestations in spinal cord sarcoidosis. J Neurol 2000;247:544-9.
  23. Clifton AG, Stevens JM, Kapoor R, Rudge P. Spinal cord sarcoidosis with intramedullary cyst formation. Br J Radiol 1990;63:805-8.
  24. Misawa M, Utsumi K, Nagate A et al. A case of spinal sarcoidosis complaining of chest and back pain as a first manifestation and mimicking syringomyelia on MRI. No To Shinkei 2002;54:337-40.
  25. Kheiralla IC, Cherfan J, Schlienger IL, Imler M. Localisation sternale d'une sarcoïdose. Rev Med Interne 1990;11:229-30.
  26. Vanek J, Vielpeau C, Brun J, Mandard JC. An unusual cause of fracture of the femoral neck: bone sarcoidosis. Rev Chir Orthop Reparatrice Appar Mot 1993;79:317-9.
  27. Rozenberg C, Laredo JD, Rozenberg S, Starre JP, Bourgeois P. Bilateral Diaphysial tibial hyperostosis: a confusing hyperostosis. Joint bone Spine 2008;75:751-2.
  28. Healy DJ, Helliwell PS. Dactylitis: pathogenesis and clinical considerations. Curr Rheumatol Rep 2006;8:338-41.
  29. Heijckmann AC, Huijberts MS, De Vries J et al. Bone turnover and hip bone mineral density in patients with sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2007;24:51-8.
  30. Heijckmann AC, Drent M, Dumitrescu B et al. Progressive vertebral deformities despite unchanged bone mineral density in patients with sarcoidosis: a 4-year follow-up study. Osteoporos Int 2008;19:839-47.
  31. Mañá J, Gómez-Vaquero C, Montero A et al. Löfgren's syndrome revisited: a study of 186 patients. Am J Med 1999;107:240-5.
  32. Mrazek F, Holla LI, Hutyrova B et al. Association of tumour necrosis factor-alpha, lymphotoxin-alpha and HLA-DRB1 gene polymorphisms with Löfgren's syndrome in Czech patients with sarcoidosis. Tissue Antigens 2005;65:163-71.
  33. Van Aken J, van Bilsen JH, Allaart CF, Huizinga TW, Breedveld FC. The Leiden Early Arthritis Clinic. Clin Exp Rheumatol 2003;21:S100-5.
  34. Mañá J, Gómez-Vaquero C, Salazar A, Valverde J, Juanola X, Pujol R. Periarticular ankle sarcoidosis: a variant of Löfgren's syndrome. J Rheumatol 1996;23:874-7.
  35. Matsuda M, Sakurai K, Fushimi T et al. Sarcoidosis with high serum levels of vascular endothelial growth factor (VEGF), showing RS3PE-like symptoms in extremities. Clin Rheumatol 2004;23:246-8.
  36. Kellner H, Späthling S, Herzer P. Ultrasound findings in Löfgren's syndrome: is ankle swelling caused by arthritis, tenosynovitis or periarthritis? J Rheumatol 1992;19:38-41.
  37. Ortiz V, Holgado S, Olivé A, Fité E. Achilles tendinitis as the presentation form of Löfgren's syndrome. Clin Rheumatol 2000;19:169-70.
  38. Sukenik S, Hendler N, Yerushalmi B, Buskila D, Liberman N. Jaccoud's-type arthropathy: an association with sarcoidosis. J Rheumatol 1991;18:915-7.
  39. Niemer GW, Bolster MB, Buxbaum L, Judson MA. Carpal tunnel syndrome in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2001;18:296-300.
  40. Fayad F, Duet M, Orcel P, Lioté F. Sarcoïdose systémique: le signe de “l'homme léopard”. Rev Rhum 2006;73:109-13.
  41. Enzenauer RJ, West SG. Sarcoidosis in autoimmune disease. Semin Arthritis Rheum 1992;22:1-17.
  42. Moore SL, Teirstein AE. Musculoskeletal Sarcoidosis: Spectrum of Appearances at MR Imaging. Radiographics 2003;23:1389-99.
  43. Yamada H, Ishii W, Ito S et al. Sarcoid myositis with muscle weakness as a presenting symptom. Mod Rheumatol 2007;17:243-6.
  44. Fayad F, Lioté F, Berenbaum F, Orcel P, Bardin T. Muscle involvement in sarcoidosis: a retrospective and followup studies. J Rheumatol 2006;33:98-103.
  45. Zámecník J, Ambler Z, Ehler E, Simková L, Mazanec R, Schützner J. Granulomatous myopathy in patients with sarcoidosis and myasthenia gravis. Cesk Patol 2006;42:175-81.
  46. Nagai Y, Hisada T, Ando M, Ishikawa O. Fatal polymyositis associated with sarcoidosis. Eur J Dermatol 2007;17:453-4.
  47. Gdynia HJ, Mogel H, Kühnlein P et al. Diagnosis and differential diagnosis of granulomatous myositis. Nervenarzt 2008;79:470-4.
  48. Le Roux K, Streichenberger N, Vial C et al. Granulomatous myositis: a clinical study of thirteen cases. Muscle Nerve 2007;35:171-7.
  49. Gardner DG. Hypercalcemia and sarcoidosis. Another piece of the puzzle falls into place. Am J Med 2001;110:736-7.
  50. Adams JS, Gacad MA, Diz MM, Nadler JL. A role for endogenous arachidonate metabolites in the regulated expression of the 25-hydroxyvitamin D-1-hydroxylation reaction in cultured alveolar macrophages from patients with sarcoidosis. J Clin Endocrinol Metab 1990;70:595-600.
  51. Falk S, Kratzsch J, Paschke R, Koch CA. Hypercalcemia as a result of sarcoidosis with normal serum concentrations of vitamin D. Med Sci Monit 2007;13:133-6.
  52. Bia MJ, Insogna K. Treatment of sarcoidosis-associated hypercalcemia with ketoconazole. Am J Kidney Dis 1991;18:702-5.
  53. Franco M, Passeron C, Tieulie N, Verdier JF, Benisvy D. Longterm radiographic follow-up in a patient with osteosclerotic sarcoidosis of the spine and pelvis. Rev Rhum Engl Ed 1998;65:586-90.
  54. Erb N, Cushley MJ, Kassimos DG, Shave RM, Kit GD. An assessment of back pain and the prevalence of sacroiliitis in sarcoidosis. Chest 2005;127:192-6.
  55. Ramos-Casals M, Brito-Zeron P, Garcia-Carrasco, Font J. Sarcoidosis or Sjogren syndrome? Clues to defining mimicry or coexistence in 59 cases. Medicine (Baltimore) 2004;83:85-95.
  56. Andonopoulos AP, Papadimitriou C, Melachrinou M et al. Asymptomatic gastrocnemius muscle biopsy: an extremely sensitive and specific test in the pathologic confirmation of sarcoidosis presenting with hilar adenopathy. Clin Exp Rheumatol 2001;19:569-72.
  57. Menkes C.J., Carter H. Traitement de la dactylite sarcoïdosique par perfusion intraveineuse brève de méthylprednisolone à forte dose. Ann Med Interne 1987;138:26-9.
  58. Kaye O, Palazzo E, Grossin M, Bourgeois P, Kahn MF, Malaise MG. Low-dose methotrexate: an effective corticosteroid-sparing agent in the musculoskeletal manifestations of sarcoidosis. Br J Rheumatol 1995;34:642-4.
  59. Gardner GC, Hunter JC. Radiographic healing of osseous sarcoidosis. Arthritis Rheum 2005;52:2225.
  60. Baughman RP, Lower EE. Infliximab for refractory sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2001;18:70-4.
  61. Baughman RP, Iannuzzi M. Tumour Necrosis Factor in sarcoidosis and its potential for targeted therapy. Biodrugs 2003;17:425-31.
  62. Ulbricht KU, Stoll M, Bierwirth J, Witte T, Schmidt RE. Successful tumor necrosis factor · blockade treatment in therapyresistant sarcoidosis. Arthritis Rheum 2003;48:3542-3.
  63. Pritchard C, Nadarajah K. Tumour necrosis factor · inhibitor treatment for sarcoidosis refractory to conventional treatments: a report of five patients. Ann Rheum Dis 2004;63:318-20.
  64. Sweiss NJ, Welsch MJ, Curran JJ, Ellman MH. Tumor Necrosis Factor inhibition as a novel treatment for refractory sarcoidosis. Arthritis Rheum 2005;53:788-91.
  65. Siame JL, Le Dantec L, Gheerbrant JD. Sarcoïdose réfractaire, effets spectaculaires des anti-TNF: un cas. Rev Rhum 2006;73:1245.
  66. Khanna D, Liebling MR, Louie JS. Etanercept ameliorates sarcoidosis arthritis and skin disease. J Rheumatol 2003;30:1864-7.
  67. Hobbs K. Chronic sarcoid arthritis treated with intraarticular etanercept. Arthritis Rheum 2005;52:987-8.
  68. Baughman RP, Lower EE, Bradley DA, Raymond LA, Kaufman A. Etanercept for Refractory Ocular Sarcoidosis. Results of a Double-Blind Randomized Trial. Chest 2005;128:1062-47.
  69. Aelion JA, Odhav SK, Aelion M. Chronic recalcitrant sarcoidosis responding to adalimumab. Arthritis Rheum 2004;50(Suppl):S137-S138.
  70. O'Shea FD et al. Pulmonary sarcoidosis developing during infliximab therapy. Arthritis Care Res 2006;55:978-81.
  71. Gonzalez-Lopez MA et al. Development of sarcoidosis during etanercept therapy. Arthritis Care Res 2006;55:817-20.
  72. Houvenagel E, Luraschi H, Maury F, Mulliez P. Sarcoïdose apparaissant sous etanercept chez une patiente suivie pour polyarthrite rhumatoïde. Rev Rhum 2007;74:1180.
  73. Gottenberg J, Guillevin L, Lambotte O et al. Tolerance and shortterm efficacy of rituximab in 43 patients with systemic autoimmune diseases. Ann Rheum Dis 2005;64:913-20.
  74. Belkhou A, Younsi R, El Bouchti I, El Hassani S. Rituximab comme alternative thérapeutique dans la sarcoïdose. Rev Rhum 2008;75:698-9.