Coexistence of immune-mediated diseases in sarcoidosis. Frequency and clinical significance in 1737 patients

Brito-Zerón, Pilar; Pérez-Álvarez, R.; Feijoo-Massó, Carlos; Gracia-Tello, Borja; González-García, Andrés; Gómez-de-la-Torre, R.; Alguacil, A.; López‐Dupla, Miguel; Robles, Ángel; García-Morillo, Salvador; Bonet, Mariona; Cruz-Caparrós, G.; Fonseca‐Aizpuru, Eva; Akasbi, M.; Callejas‐Rubio, José Luis; Miguel‐Campo, Borja de; Pérez-de-Lis, M.; Ramos‐Casals, Manuel; De-Escalante, B.; Chara-Cervantes, J.; Pérez-Conesa, M.; Rascón, Javier; Pallarés, L; Guerrero, P. Pérez; De-la-Red, G.; Calvo, Eva; Soler, Cristina; Peral-Gutiérrez, E.; Gómez-Cerezo, J; Rodríguez-Fernández, S.; Pinilla, Blanca; Toledo-Samaniego, Neera; Gato, A.; Chamorro, Antonio-Javier; Morcillo, César; Ojeda, I; Vives, M.J.; de-Miguel, B.; Penadés, M.; De-Vicente, M.

doi:10.1016/j.jbspin.2021.105236

Cited by 24 publications

(30 citation statements)

References 51 publications

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“…Moreover, the procedure allowed us to improve differential diagnoses for our patients initially suspected to have pSS (such as granulomatous sialadenitis consistent with sarcoidosis and IgG4-related disease). These findings emphasise the importance of SG biopsies—especially in patients with pSS with glandular swelling—in order to detect not only lymphoproliferative disease but also less common diseases that would otherwise be underdiagnosed 40–42…”

Section: Discussionmentioning

confidence: 87%

“…These findings emphasise the importance of SG biopsies-especially in patients with pSS with glandular swelling-in order to detect not only lymphoproliferative disease but also less common diseases that would otherwise be underdiagnosed. [40][41][42] Furthermore, this new sampling technique might provide histological material from the major SGs that offers possible future research implications for tissue sampling. 21 It may also provide superior diagnostic accuracy while improving prognostic value, 39 allowing for the monitoring of disease activity and tissue damage 10 43 as well as patients' response to treatment.…”

Section: Discussionmentioning

confidence: 99%

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Safety, patient acceptance and diagnostic accuracy of ultrasound core needle biopsy of parotid or submandibular glands in primary Sjögren’s syndrome with suspected salivary gland lymphoma

et al. 2022

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BackgroundEnlargement of the major salivary glands (SGs) is a major risk factor for B-cell lymphoma among patients with primary Sjögren’s syndrome (pSS). Ultrasound-guided core needle biopsy (US-guided CNB) could be a novel technique to manage SG enlargement among patients with pSS.ObjectiveAccordingly, this study’s main aim was to evaluate the safety, patient tolerance and diagnostic accuracy of US-guided CNB procedure for patients with pSS with major SG enlargement.MethodsPatients with clinical diagnosis of pSS and a clinical indication for SG biopsy consecutively underwent US-guided CNB between September 2019 and June 2021. These patients were evaluated clinically 1, 2 and 12 weeks after US-guided CNB. Patients were asked to complete a questionnaire about postprocedural complications as well as periprocedural pain, using the Visual Analogue Scale. Complications were categorised as transient (<12 weeks) or persistent (≥12 weeks).ResultsUS-guided CNB was performed on 30 major salivary glands (22 parotid glands and 8 submandibular glands). The procedure was well tolerated. Transient complications—such as haematoma, swelling—were observed among 43% of patients, and mean periprocedural pain was low. However, no persistent complications were reported during the study’s follow-up period.ConclusionUS-guided CNB represents a novel approach for the management of patients with pSS with SG enlargement. The procedure showed remarkable patient safety and tolerance, allowing adequate glandular sampling and a definite diagnosis for almost all participating patients without long-term complications.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Safety, patient acceptance and diagnostic accuracy of ultrasound core needle biopsy of parotid or submandibular glands in primary Sjögren’s syndrome with suspected salivary gland lymphoma

et al. 2022

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“…Although rare, the association of thrombocytopenia with sarcoidosis has been fully documented and well described. A study involving 1737 patients with sarcoidosis proved a strong association (OR 8.43) between immune thrombocytopenia and sarcoidosis [ 5 ] .…”

Section: Discussionmentioning

confidence: 99%

“…Interestingly, our patient showed no other cytopenia or splenomegaly, her peripheral smear was unremarkable, and there was no identified secondary cause, so primary ITP was assumed. Also, there was a good response to immunosuppression therapy, supporting an immune process causing platelet destruction [ 3 , 5 ] .…”

Section: Discussionmentioning

confidence: 99%

Immune Thrombocytopenia: A Rare Presentation of Pulmonary Sarcoidosis

Leal

Amado

Paracana

et al. 2021

European Journal of Case Reports in Internal Medicine

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Thrombocytopenia may be the initial presentation of sarcoidosis, which is a systemic granulomatous disorder. Various pathophysiological mechanisms have been identified. Immune thrombocytopenia often has a severe presentation but may respond favourably to immunosuppressive therapy. There are no guidelines for the treatment of thrombocytopenia in sarcoidosis. However, in emergency situations with major bleeding, it seems reasonable to apply the current guidelines recommended for immune thrombocytopenia. The authors report a case of sarcoidosis presenting with severe thrombocytopenia, petechial rash, and nasal and gingival bleeding.

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“…Sarcoidosis does not meet the criteria for an autoimmune disorder, but its coexistence with various autoimmune diseases has been well documented [12]. Up to the present time, this association has been analyzed in different settings: case reports, population-based studies as well as in four studies that specifically investigated the overlap of sarcoidosis and immune-mediated diseases [13,14,15,16].…”

Section: Sarcoidosis and Rheumatic Autoimmune Diseasesmentioning

confidence: 99%

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2021

AnnalsARSciMed

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Sarcoidosis is a multisystem inflammatory disease of incompletely elucidated etiology. It is characterized by the formation of non-caseating granulomas which can be found in any organ or tissue. The most commonly affected organ is the lung and the typical presentation is with bilateral hilar lymphadenopathy, pulmonary infiltrates, and cutaneous and ocular symptoms. However, as the granulomatous reaction can take place in any organ and tissue, sarcoidosis can have variable clinical presentations. It is well documented that sarcoidosis may mimic a great array of autoimmune and non-autoimmune diseases. Moreover, it can also coexist with these disorders, which makes the diagnostic pathway all the more challenging.

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Coexistence of immune-mediated diseases in sarcoidosis. Frequency and clinical significance in 1737 patients

Cited by 24 publications

References 51 publications

Safety, patient acceptance and diagnostic accuracy of ultrasound core needle biopsy of parotid or submandibular glands in primary Sjögren’s syndrome with suspected salivary gland lymphoma

Safety, patient acceptance and diagnostic accuracy of ultrasound core needle biopsy of parotid or submandibular glands in primary Sjögren’s syndrome with suspected salivary gland lymphoma

Immune Thrombocytopenia: A Rare Presentation of Pulmonary Sarcoidosis

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