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Peris P Font J Grau JM Martínez de Osaba MJ Filella X Muñoz-Gómez J 《Clinical rheumatology》1999,18(6):488-491
In this report we describe a patient with Sjo¨gren’s syndrome (SS) and calcitriol-mediated hypercalcaemia. Initially, there
was no clinical evidence of sarcoidosis. The patient had hypercalcaemia associated with increased calcitriol serum levels;
circulating interleukin-6 and tumour necrosis factor alpha levels were also elevated. At the beginning, therapy with clodronate
was effective in decreasing the serum calcium levels. However, the serum calcitriol decreased only after chloroquine treatment
was added. After 2 years of therapy, the patient developed progressive and extensive muscle weakness. A muscle biopsy revealed
a very prominent non-caseating granulomatous myopathy. Corticosteroid therapy was then instituted. Although both chloroquine
and corticosteroid therapy were associated with decreased serum interleukin and calcitriol levels, only corticosteroid therapy
was effective in treating the sarcoid myopathy. The role of cytokines in calcitriol mediated hypercalcaemia is discussed.
Received: 1 February 1999 / Accepted: 2 June 1999 相似文献
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Akasbi Nessrine Abourazzak Fatima Zahra Harzy Taoufik 《Jornal brasileiro de pneumologia》2014,40(2):175-182
Sarcoidosis is a multisystem inflammatory disorder of unknown cause. It most commonly
affects the pulmonary system but can also affect the musculoskeletal system, albeit
less frequently. In patients with sarcoidosis, rheumatic involvement is polymorphic.
It can be the presenting symptom of the disease or can appear during its progression.
Articular involvement is dominated by nonspecific arthralgia, polyarthritis, and
Löfgren''s syndrome, which is defined as the presence of lung adenopathy, arthralgia
(or arthritis), and erythema nodosum. Skeletal manifestations, especially dactylitis,
appear mainly as complications of chronic, multiorgan sarcoidosis. Muscle involvement
in sarcoidosis is rare and usually asymptomatic. The diagnosis of rheumatic
sarcoidosis is based on X-ray findings and magnetic resonance imaging findings,
although the definitive diagnosis is made by anatomopathological study of biopsy
samples. Musculoskeletal involvement in sarcoidosis is generally relieved with
nonsteroidal anti-inflammatory drugs or corticosteroids. In corticosteroid-resistant
or -dependent forms of the disease, immunosuppressive therapy, such as treatment with
methotrexate or anti-TNF-α, is employed. The aim of this review was to present an
overview of the various types of osteoarticular and muscle involvement in
sarcoidosis, focusing on their diagnosis and management. 相似文献
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Loida Ayala Douglas B. Barber Maria R. Lomba Antoinne C. Able 《The journal of spinal cord medicine》2013,36(2):96-99
AbstractSarcoidosis is a chronic, multisystem noncaseating granulomatous disease of unknown etiology. Sarcoidosis typically presents clinically in individuals between the ages of 20 and 40 years. Although sarcoidosis most commonly affects the respiratory system, nearly any organ system can be involved. Spinal cord involvement by sarcoidosis is a rare event, occurring in less than 1% of patients with systemic disease. The case presented is that of a 29-year-old black male with benign past medical history who presented with a 6-week history of progressive incomplete paraplegia arid bowel dysfunction. Magnetic resonance imaging revealed an intramedullary mass at the T-4-T-5 levels. The patient underwent thoracic laminectomy and debulking of the mass. The pathology was consistent with granulomatous disease. Postoperatively, the patient was placed on prednisone. He subsequently received comprehensive inpatient and outpatient rehabilitation and at present is bowel and bladder continent and ambulating at community levels with a rolling walker. The diagnosis of sarcoidosis; potential treatment options, including debulking and long-term steroid use; and prognosis will be discussed. 相似文献
17.
《Respiratory investigation》2020,58(6):479-487
BackgroundSome patients with sarcoidosis experience worsening of pulmonary lesions. However, no biomarker has been identified that reflects pulmonary disease status in sarcoidosis. We investigated the usefulness of potential markers of pulmonary fibrosis in patients with sarcoidosis.MethodsPlasma matrix metalloproteinase 7 (MMP-7), CC-chemokine ligand 18 (CCL-18), and periostin levels were evaluated in 60 patients with sarcoidosis and 30 healthy controls; bronchoalveolar lavage fluid levels were analyzed in 22 patients with sarcoidosis. To determine the usefulness of these markers, we explored potential correlations between these markers and sarcoidosis clinical characteristics.ResultsPlasma MMP-7, CCL-18, and periostin concentrations were significantly higher in patients with sarcoidosis than those in healthy controls. MMP-7 concentrations in plasma and bronchoalveolar lavage fluid were higher in patients with sarcoidosis with parenchymal infiltration than in those without lung lesions. Moreover, MMP-7 concentration was negatively correlated with pulmonary function.ConclusionAmong these novel biomarkers, MMP-7 most precisely reflected pulmonary sarcoidosis disease status and thus, might be useful for diagnosing and evaluating sarcoidosis, particularly in patients with pulmonary parenchymal lesions. 相似文献
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《Modern rheumatology / the Japan Rheumatism Association》2013,23(4):356-359
AbstractPrimary Sjögren's syndrome (SS), sarcoidosis (SA), and psoriasis vulgaris (PV) are all chronic diseases of unknown etiology. Recent studies suggest that activated T cells play a central role in their pathogenesis. We describe a case of a Japanese woman with primary SS complicated by SA and PV. To our knowledge, this is the first case in which these three diseases coexist. Although these three disorders may have a common immunopathogenic mechanism, the extreme rarity of their coexistence suggests that distinct etiological mechanisms are also involved and appear to play an important role in triggering and developing each disease. 相似文献
20.