Chronic Inflammatory Arthropathy Preceding Acute Systemic Manifestations of Sarcoidosis: A Possible Overlap of Idiopathic Juvenile Arthritis and Sarcoidosis
Identifieur interne : 000958 ( Main/Exploration ); précédent : 000957; suivant : 000959Chronic Inflammatory Arthropathy Preceding Acute Systemic Manifestations of Sarcoidosis: A Possible Overlap of Idiopathic Juvenile Arthritis and Sarcoidosis
Auteurs : Matheus Campello Vieira [Brésil] ; Priscilla Gomes Tosta [Brésil] ; Fernanda Morello Nicole [Brésil] ; Lucas Enock V. Roberto [Brésil] ; Júlia Guasti P. Vianna [Brésil] ; Paulo De Coelho Castro [Brésil] ; Rafael Burgomeister Lourenço [Brésil] ; Erica Vieira Serrano [Brésil] ; Valéria Valim [Brésil] ; Weverton Machado Luchi [Brésil]Source :
- Case Reports in Rheumatology [ 2090-6889 ] ; 2019.
Abstract
Sarcoidosis is a multisystem disease with unknown etiology, marked by T lymphocytes and macrophages agglomeration, which leads to the formation of noncaseating granulomas in the affected tissues. We describe a case of a 40-year-old black patient referred to our service for evaluation of nephrolithiasis and persistent elevation of plasma creatinine. He reported important weight loss, fever episodes, and abdominal and low back intermittent pain in the past 6 months. The investigation revealed elevated serum calcium level, hepatosplenomegaly, retroperitoneal lymphadenopathy, anemia, thrombocytopenia, and nephrolithiasis. The initial diagnostic hypothesis was lymphoproliferative disease, but the laparoscopic propaedeutic showed multiple white lesions on the liver surface, which biopsy identified as noncaseating granulomas with asteroid corpuscles, suggestive of sarcoidosis. He was treated with corticosteroids with significant improvement in symptoms and in calcium and creatinine levels. Besides, the patient presented a long-term large joints arthropathy, especially on the knees (with bilateral prosthesis), wrists, and ankles, of unknown etiology. We discuss the systemic manifestations of sarcoidosis related to the reported case, as well as the possible overlapping of idiopathic juvenile arthritis with sarcoidosis.
Url:
DOI: 10.1155/2019/6483245
PubMed: 31886005
PubMed Central: 6925795
Affiliations:
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uniqKey="Vieira M" first="Matheus Campello" last="Vieira">Matheus Campello Vieira</name><affiliation wicri:level="2"><nlm:aff id="I1">Federal University of Espírito Santo (UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Federal University of Espírito Santo (UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author><author><name sortKey="Tosta, Priscilla Gomes" sort="Tosta, Priscilla Gomes" uniqKey="Tosta P" first="Priscilla Gomes" last="Tosta">Priscilla Gomes Tosta</name><affiliation wicri:level="2"><nlm:aff id="I1">Federal University of Espírito Santo (UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Federal University of Espírito Santo (UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author><author><name sortKey="Nicole, Fernanda Morello" sort="Nicole, Fernanda Morello" uniqKey="Nicole F" first="Fernanda Morello" last="Nicole">Fernanda Morello Nicole</name><affiliation wicri:level="2"><nlm:aff id="I2">Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author><author><name sortKey="Roberto, Lucas Enock V" sort="Roberto, Lucas Enock V" uniqKey="Roberto L" first="Lucas Enock V." last="Roberto">Lucas Enock V. Roberto</name><affiliation wicri:level="2"><nlm:aff id="I1">Federal University of Espírito Santo (UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Federal University of Espírito Santo (UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author><author><name sortKey="Vianna, Julia Guasti P" sort="Vianna, Julia Guasti P" uniqKey="Vianna J" first="Júlia Guasti P." last="Vianna">Júlia Guasti P. Vianna</name><affiliation wicri:level="2"><nlm:aff id="I2">Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author><author><name sortKey="Castro, Paulo De Coelho" sort="Castro, Paulo De Coelho" uniqKey="Castro P" first="Paulo De Coelho" last="Castro">Paulo De Coelho Castro</name><affiliation wicri:level="2"><nlm:aff id="I1">Federal University of Espírito Santo (UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Federal University of Espírito Santo (UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author><author><name sortKey="Lourenco, Rafael Burgomeister" sort="Lourenco, Rafael Burgomeister" uniqKey="Lourenco R" first="Rafael Burgomeister" last="Lourenço">Rafael Burgomeister Lourenço</name><affiliation wicri:level="2"><nlm:aff id="I3">Radiology Service, Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Radiology Service, Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author><author><name sortKey="Serrano, Erica Vieira" sort="Serrano, Erica Vieira" uniqKey="Serrano E" first="Erica Vieira" last="Serrano">Erica Vieira Serrano</name><affiliation wicri:level="2"><nlm:aff id="I4">Rheumatology Service, Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Rheumatology Service, Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author><author><name sortKey="Valim, Valeria" sort="Valim, Valeria" uniqKey="Valim V" first="Valéria" last="Valim">Valéria Valim</name><affiliation wicri:level="2"><nlm:aff id="I4">Rheumatology Service, Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Rheumatology Service, Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author><author><name sortKey="Luchi, Weverton Machado" sort="Luchi, Weverton Machado" uniqKey="Luchi W" first="Weverton Machado" last="Luchi">Weverton Machado Luchi</name><affiliation wicri:level="2"><nlm:aff id="I5">Nephrology Service, Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES, Brazil</nlm:aff><country xml:lang="fr">Brésil</country><wicri:regionArea>Nephrology Service, Cassiano Antonio de Moraes Hospital, Federal University of Espírito Santo (HUCAM/UFES), Vitória, ES</wicri:regionArea><placeName><region type="state">Espírito Santo</region></placeName></affiliation></author></analytic><series><title level="j">Case Reports in Rheumatology</title><idno type="ISSN">2090-6889</idno><idno type="eISSN">2090-6897</idno><imprint><date when="2019">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>Sarcoidosis is a multisystem disease with unknown etiology, marked by T lymphocytes and macrophages agglomeration, which leads to the formation of noncaseating granulomas in the affected tissues. We describe a case of a 40-year-old black patient referred to our service for evaluation of nephrolithiasis and persistent elevation of plasma creatinine. He reported important weight loss, fever episodes, and abdominal and low back intermittent pain in the past 6 months. The investigation revealed elevated serum calcium level, hepatosplenomegaly, retroperitoneal lymphadenopathy, anemia, thrombocytopenia, and nephrolithiasis. The initial diagnostic hypothesis was lymphoproliferative disease, but the laparoscopic propaedeutic showed multiple white lesions on the liver surface, which biopsy identified as noncaseating granulomas with asteroid corpuscles, suggestive of sarcoidosis. He was treated with corticosteroids with significant improvement in symptoms and in calcium and creatinine levels. Besides, the patient presented a long-term large joints arthropathy, especially on the knees (with bilateral prosthesis), wrists, and ankles, of unknown etiology. We discuss the systemic manifestations of sarcoidosis related to the reported case, as well as the possible overlapping of idiopathic juvenile arthritis with sarcoidosis.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Iannuzzi, M C" uniqKey="Iannuzzi M">M. C. Iannuzzi</name></author><author><name sortKey="Rybicki, B A" uniqKey="Rybicki B">B. A. Rybicki</name></author><author><name sortKey="Teirstein, A S" uniqKey="Teirstein A">A. S. Teirstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Chen, E S" uniqKey="Chen E">E. S. Chen</name></author><author><name sortKey="Moller, D R" uniqKey="Moller D">D. R. Moller</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Renaghan, A D" uniqKey="Renaghan A">A. D. Renaghan</name></author><author><name sortKey="Rosner, M H" uniqKey="Rosner M">M. H. 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Donck</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Thosani, S" uniqKey="Thosani S">S. Thosani</name></author><author><name sortKey="Hu, M I" uniqKey="Hu M">M. I. Hu</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Bargagli, E" uniqKey="Bargagli E">E. Bargagli</name></author><author><name sortKey="Prasse, A" uniqKey="Prasse A">A. Prasse</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Baughman, R P" uniqKey="Baughman R">R. P. Baughman</name></author><author><name sortKey="Grutters, J C" uniqKey="Grutters J">J. C. Grutters</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Deutsch Link, S" uniqKey="Deutsch Link S">S. Deutsch-Link</name></author><author><name sortKey="Fortuna, D" uniqKey="Fortuna D">D. Fortuna</name></author><author><name sortKey="Weinberg, E" uniqKey="Weinberg E">E. Weinberg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Dulai, P S" uniqKey="Dulai P">P. S. Dulai</name></author><author><name sortKey="Rothstein, R I" uniqKey="Rothstein R">R. I. Rothstein</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Judson, M A" uniqKey="Judson M">M. A. Judson</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Harder, H" uniqKey="Harder H">H. Harder</name></author><author><name sortKey="Buchler, M W" uniqKey="Buchler M">M. W. Büchler</name></author><author><name sortKey="Frohlich, B" uniqKey="Frohlich B">B. Fröhlich</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Gebreselassie, A" uniqKey="Gebreselassie A">A. Gebreselassie</name></author><author><name sortKey="Mehari, A" uniqKey="Mehari A">A. Mehari</name></author><author><name sortKey="Dagne, R" uniqKey="Dagne R">R. Dagne</name></author><author><name sortKey="Berhane, F" uniqKey="Berhane F">F. Berhane</name></author><author><name sortKey="Kibreab, A" uniqKey="Kibreab A">A. Kibreab</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Brésil</li></country><region><li>Espírito Santo</li></region></list><tree><country name="Brésil"><region name="Espírito Santo"><name sortKey="Vieira, Matheus Campello" sort="Vieira, Matheus Campello" uniqKey="Vieira M" first="Matheus Campello" last="Vieira">Matheus Campello Vieira</name></region><name sortKey="Castro, Paulo De Coelho" sort="Castro, Paulo De Coelho" uniqKey="Castro P" first="Paulo De Coelho" last="Castro">Paulo De Coelho Castro</name><name sortKey="Lourenco, Rafael Burgomeister" sort="Lourenco, Rafael Burgomeister" uniqKey="Lourenco R" first="Rafael Burgomeister" last="Lourenço">Rafael Burgomeister Lourenço</name><name sortKey="Luchi, Weverton Machado" sort="Luchi, Weverton Machado" uniqKey="Luchi W" first="Weverton Machado" last="Luchi">Weverton Machado Luchi</name><name sortKey="Nicole, Fernanda Morello" sort="Nicole, Fernanda Morello" uniqKey="Nicole F" first="Fernanda Morello" last="Nicole">Fernanda Morello Nicole</name><name sortKey="Roberto, Lucas Enock V" sort="Roberto, Lucas Enock V" uniqKey="Roberto L" first="Lucas Enock V." last="Roberto">Lucas Enock V. Roberto</name><name sortKey="Serrano, Erica Vieira" sort="Serrano, Erica Vieira" uniqKey="Serrano E" first="Erica Vieira" last="Serrano">Erica Vieira Serrano</name><name sortKey="Tosta, Priscilla Gomes" sort="Tosta, Priscilla Gomes" uniqKey="Tosta P" first="Priscilla Gomes" last="Tosta">Priscilla Gomes Tosta</name><name sortKey="Valim, Valeria" sort="Valim, Valeria" uniqKey="Valim V" first="Valéria" last="Valim">Valéria Valim</name><name sortKey="Vianna, Julia Guasti P" sort="Vianna, Julia Guasti P" uniqKey="Vianna J" first="Júlia Guasti P." last="Vianna">Júlia Guasti P. Vianna</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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