Coexistence of Ankylosing Spondylitis and Löfgren’s Syndrome

Kobak, Şenol; Sever, Fidan; Sivrikoz, Oya Nermin; Karaarslan, Ahmet

doi:10.1155/2014/747698

Cited by 5 publications

(4 citation statements)

References 11 publications

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“…Sarcoidosis was reported together with different rheumatologic disorders (e.g Sjögren's syndrome, ankylosing spondylitis, scleroderma) [Kobak et al 2013[Kobak et al , 2014b. There are studies showing that sarcoidosis may mimic their clinical and laboratory findings.…”

Section: Association Of Sarcoidosis and Rheumatologic Diseasesmentioning

confidence: 99%

Sarcoidosis: a rheumatologist’s perspective

Kobak

2015

Therapeutic Advances in Musculoskeletal

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Sarcoidosis is a systemic disorder of unknown etiology, which may involve various tissues and organs and is characterized by a noncaseating granuloma reaction. While pathogenesis is not yet clear, cellular immune system activation and nonspecific inflammatory response occur secondarily to several genetic and environmental factors. T helper 1-cells and macrophage-derived pro-inflammatory cytokines stimulate the inflammatory cascade and formation of granuloma occurs as a result of tissue permeability, cell influx, and local cell proliferation. The different prevalence, clinical results, and disease course observed in different races and ethnic groups, is an indicator of the heterogeneous nature of the disease. Sarcoidosis may mimic and/or may occur concomitantly with numerous primary rheumatic diseases. This disease most commonly presents with bilateral hilar lymphadenopathy, pulmonary infiltrations, and skin and eye lesions. Locomotor system involvement is observed at a range of 15% and 25%. Two major joint involvements have been described: acute and chronic form. The most common form, the acute form, may be the first sign of sarcoidosis and present with arthralgia, arthritis, or periarthritis. Chronic sarcoid arthritis is usually associated with pulmonary parenchymal disease or other organ involvement and occurs rarely. While asymptomatic muscular involvement is reported between 25% and 75%, symptomatic muscular involvement is very rare. Symptomatic myopathy may present as three different types: chronic myopathy, palpable nodular myositis, or acute myositis. Even if rare, 2-5% of cases may exhibit osseous involvement and it is frequently associated with lupus pernio, chronic uveitis, and multisystemic disease. Sarcoidosis was reported together with different rheumatologic diseases. There are studies showing that sarcoidosis may mimic the clinical and laboratory findings of these disorders. Nonsteroidal anti-inflammatory drugs and corticosteroids are used for treating the symptoms of rheumatologic findings. In patients who are unresponsive to corticosteroids, immunosuppressive and anti-tumor necrosis factor alpha drugs may be used. In this review, the incidence of rheumatologic symptoms, the clinical findings, and the treatment of rheumatologic manifestations of sarcoidosis are discussed.

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Section: Association Of Sarcoidosis and Rheumatologic Diseasesmentioning

confidence: 99%

Sarcoidosis: a rheumatologist’s perspective

Kobak

2015

Therapeutic Advances in Musculoskeletal

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“…5 However, the correlation between autoimmune diseases and sarcoidosis has been reported frequently, including systemic lupus erythematosus (SLE), autoimmune hepatitis, celiac disease, systemic sclerosis, rheumatoid arthritis (RA), Sj€ ogren's syndrome (SS), ankylosing spondylitis (AS), hypothyroidism and Graves' disease. 2,[6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] Nevertheless, most of these studies fall into the category of either case reports 8,10,[13][14][15][16][17][18][19][20][21][22] or small to medium hospital-based studies, 6,7,9 and the clinical significance of the association remains unclear. The main objective of this nationwide population-based case-control study in Taiwan is to clarify the autoimmune profiles in sarcoidosis patients.…”

Section: Introductionmentioning

confidence: 99%

Comorbid autoimmune diseases in patients with sarcoidosis: A nationwide case–control study in Taiwan

Chung

et al. 2016

The Journal of Dermatology

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The association between sarcoidosis and autoimmune comorbidities has been reported, however, it has seldom been confirmed by a large nationwide study. Our study aimed to clarify the association between sarcoidosis and autoimmune comorbidities in the Taiwanese. A total of 1237 patients with sarcoidosis and 4948 age- and sex-matched control subjects were selected from the National Health Insurance Research Database of Taiwan from 1997 to 2010. Multiple logistic regressions were performed to calculate the odds of comorbidities between the two groups. The prevalence of sarcoidosis was 2.17/100 000 individuals in Taiwan. Sarcoidosis patients tended to run a higher risk of autoimmune comorbidities than the control group (17.6% vs 9.4%, P < 0.05). Autoimmune thyroid disease (adjusted odd ratio [aOR], 1.32; 95% confidence interval [CI], 1.05-1.64), Sjögren's syndrome (aOR, 11.6; 95% CI, 4.36-31.0) and ankylosing spondylitis (aOR, 3.80; 95% CI, 2.42-5.97) were significantly associated with sarcoidosis. The sex-stratified analyses were carried out to demonstrate a significant association of sarcoidosis with ankylosing spondylitis in both sexes, but with autoimmune thyroid disease in male patients and with Sjögren's syndrome female patients, respectively. Besides, the diagnosis of the autoimmune comorbidities strongly associated with sarcoidosis tended to be established after that of sarcoidosis. This study demonstrated that patients with sarcoidosis tended to have autoimmune thyroid disease, Sjögren's syndrome and ankylosing spondylitis, and the diagnosis of sarcoidosis usually preceded that of associated comorbidities. Clinicians should be alert to autoimmune comorbidities in patients with sarcoidosis.

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“…10 The presence of certain HLA genotypes can confer either increased risk or protection in both sarcoidosis and certain CTDs. 11,12 In particular, the HLA-DRB1 allele has been associated with sarcoidosis, Sjögren's syndrome, and rheumatoid arthritis (RA). 13 Increased expression of certain cytokines (interleukin-5 [IL-5], CCL2) are observed in systemic sclerosis (SSc), psoriatic arthritis, and sarcoidosis patients with advanced fibrotic lung disease.…”

Section: Connective Tissue Diseasementioning

confidence: 99%

Overlap Syndromes in Sarcoidosis: Clinical Features and Outcomes

James

2020

Semin Respir Crit Care Med

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Sarcoidosis is a multisystem inflammatory disease characterized by noncaseating granulomatous inflammation. While pulmonary sarcoidosis is most common, extrapulmonary involvement occurs in 50 to 74% of patients and can be the presenting abnormality in some patients. The diagnosis of sarcoidosis is based on a compatible clinical presentation in combination with granulomas on histology and exclusion of other causes. However, the absence of a diagnostic biomarker for sarcoidosis, in addition to the overlap of granulomatous inflammation and nonspecific clinical findings with other diseases, often results in a delayed diagnosis. Sarcoidosis overlap syndromes are typically described when sarcoidosis is diagnosed in the presence of another disease (concurrently or sequentially) with shared clinical and histologic features, or when sarcoidosis presents with clinical features typically observed in, but not diagnostic of, other diseases. Awareness of overlap syndromes is important for clinicians to avoid diagnostic errors and evaluate for concomitant diagnoses that may impact the management and outcome of sarcoidosis. This article is intended to provide an overview of these presentations and the most commonly associated diseases, with attention to their prevalence, clinical features, and reciprocal impacts on disease outcomes.

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Coexistence of Ankylosing Spondylitis and Löfgren’s Syndrome

Cited by 5 publications

References 11 publications

Sarcoidosis: a rheumatologist’s perspective

Sarcoidosis: a rheumatologist’s perspective

Comorbid autoimmune diseases in patients with sarcoidosis: A nationwide case–control study in Taiwan

Overlap Syndromes in Sarcoidosis: Clinical Features and Outcomes

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