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Infiltrative Optic Neuropathies
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Aniruddha Agarwal, Sabia Handa, Vishali Gupta
Sarcoidosis is an inflammatory multisystem disorder of unknown etiology. Ocular involvement in sarcoidosis is common and can occur at any time during the course of the disease and can even predate the disease. Ocular manifestations vary enormously and include granulomatous or non-granulomatous anterior uveitis, intermediate uveitis, retinal periphlebitis, multifocal choroiditis, papillitis, optic nerve granuloma, lacrimal gland enlargement and, rarely, orbital involvement or scleritis.65–68
Sarcoidosis
Published in Charles Theisler, Adjuvant Medical Care, 2023
About half of all patients with sarcoidosis get better without treatment. There-fore, the decision to provide treatment must be weighed against the risks of using corticosteroids, the most common therapy. A general rule is to consider instituting corticosteroid treatment when organ function is threatened.4 The relapse rate after corticosteroid therapy is withdrawn may be as high as 70%.5 Goals in the treatment of sarcoidosis are to control symptoms, prevent complications, and improve outcomes in patients with persistent sarcoidosis.
Inflammatory, Hypersensitivity and Immune Lung Diseases, including Parasitic Diseases.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
Clinical course - Most patients with sarcoidosis are aged 20 to 55 (peak ages 20 to 35), and the condition is almost unknown before the mid teens. Female to male ration is about 2: 1. As well as a peak in young women, there is a second peak incidence in older women, who are more likely to have symptoms. Few patients are very ill, but quite a number have a moderate malaise, with sweating, discomfort from uveitis, swelling of cervical lymph nodes, joint pains, etc. Some have transitory erythema nodosum (see p. 23.6 and Illus. ERYTHEMA NODOSUM). In a few the malaise can be quite marked, with considerable systemic upset, hypercalcaemia and altered calcium metabolism, a very painful arthropathy, etc. Rarely the patients may be very ill with intra-vascular coagulation and a gross systemic upset.
Diagnostic accuracy of interleukin-2 receptor in sarcoidosis: a systematic review and meta-analysis
Published in Expert Review of Respiratory Medicine, 2023
Dan Qin, Li-Li Fan, Yuxia Zhong, Yongchun Shen, Deyun Cheng
The study was included in this meta-analysis if it fulfilled the following criteria: (1) it tested the value of sIL-2 R levels as a diagnostic tool in clinically diagnosed or biopsy-proven sarcoidosis patients as subjects and contained a control group; (2) it reported enough data to calculate true positive (TP), false positive (FP), false negative (FN), and true negative (TN) rates; and (3) it was an original research article. In the included studies, patients with sarcoidosis were diagnosed by clinical, pathological biopsy, or both. Patients treated with immunosuppressive medication were excluded [19,21,22]， and none of the participants were treated with steroids or any sarcoidosis medications [8,23,24]. These studies were conducted on patients with pulmonary and extrapulmonary sarcoidosis without age and treatment limitation. Studies that lacked a control group or focused solely on the prognostic performance of sIL-2 receptor levels were excluded. Conference abstracts, editorial reviews, duplicate studies, and research with less than 20 patients were among the studies that were excluded.
Sarcoidosis presenting as acute pericarditis. A case report and review of pericardial sarcoidosis
Published in Acta Cardiologica, 2022
Alexandre Unger, Philippe Unger, Raphaël Mottale, Mihaela Amzulescu, Abraham J. Beun
To the best of our knowledge, this is the second case of a patient presenting with clinical features consistent with acute pericarditis as the first manifestation of sarcoidosis [5]. The diagnosis of sarcoidosis requires clinical, radiological and pathological assessment. In this case, the diagnosis was ascertained by the findings of non-caseous granulomatosis on mediastinal lymph node biopsy and by the uptake pattern on PET/CT. Other infectious causes were excluded by an extensive work-up including serology and microbiological analysis of the biopsy sample. The findings of ANA with anti-SSA specificity and rheumatoid factor, in the absence of auto-immune disease is likely explained by an exaggerated immune response [6]. The combination of typical pericardial chest pain, widespread concave ST elevation and pericardial effusion is consistent with the diagnosis of acute pericarditis [7]. MRI was vital in ruling out myocardial involvement. Furthermore, no ECG or wall motion abnormality suggestive of myocardial sarcoidosis could be detected after the acute event [8].
Infliximab for relapsing neurosarcoidosis recurring after kidney transplantation: a case report
Published in Acta Clinica Belgica, 2021
Nicolas Hanset, Mawufemo Yawovi Tsevi, Thierry Duprez, Adrian Ivanoiu, Arnaud Devresse, Nathalie Demoulin, Nada Kanaan
Sarcoidosis is a multisystem inflammatory disease of unknown aetiology, which usually affects young adults. Both genetic and environmental factors may be involved in the pathophysiology of the disease. It is noteworthy that our patient carried both HLA-DRB1 and HLA-DQB1 alleles, which have been consistently associated with sarcoidosis.1 Nervous system involvement is rare. Neurosarcoidosis most frequently affects cranial nerves, but also meninges and parenchyma. It may occur several years after the initial diagnosis.2 Clinical features are variable, including cranial nerve palsies (most frequently II, VII, VIII), neurological or endocrine dysfunctions, hydrocephalus, seizure, myalgias, cognitive or psychiatric symptoms.3 Best-suited diagnostic investigations are gadolinium-enhanced MRI and CSF analysis.2 As in our patient, contrast-enhanced T1-weighted images reveal leptomeningeal thickening with focal or diffuse enhancement (Figure 1(c)). Parenchymal lesions appear as contrast-enhanced foci of variable size (Figure 1(a,b)).4 Analysis of CSF reveals non-specific lymphocytic inflammation, often with elevated protein levels and sometimes with decreased glucose ones. ACE levels in both CSF and serum are less helpful in the diagnosis given their low sensitivity and specificity.3,4