Extrapulmonary Sarcoidosis

Judson, Marc A.

doi:10.1055/s-2007-970335

Cited by 119 publications

(131 citation statements)

References 145 publications

(293 reference statements)

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“…Typical clinical manifestations are easier recognized, but unsual presentations, such as nodular lesions of spleen and/or liver, are difficult to diagnose in absence of clinical suspicious of sarcoidosis [1,3,9]. The diagnosis of sarcoidosis could be more complicated especially if abdominal sarcoidosis represents the exclusive involvement without systemic disease [3,6,9]. Usually, extrapulmonary disease occurs in the context of more extensive chest disease [13,14,15] (greatest splenic dimension >14 cm) is the most common splenic manifestation [19,20].…”

Section: Discussionmentioning

confidence: 99%

Unusual Presentation Of Sarcoidosis: Case Report

Tatiana

Mazilu

Crăciun

et al. 2017

ARS Medica Tomitana

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Sarcoidosis is a multisystem granulomatous disease with polymorphic manifestations, of unknown etiology, that can affect any organ in the body, but most commonly the lungs [1,2,3]. Extrapulmonary involvement is common, can occur in association with or in the absence of intrathoracic disease, and all organs can be involved, but it is rare to find an isolated extrapulmonary disease (less than 10% of patients) [3,4]. On occasion, the presentation of sarcoidosis may be atypical. We report a case of systemic sarcoidosis, with particular clinical data: extrathoracic onset with subdiaphragmatic lymph nodes, hepatomegaly and splenomegaly. Personal history and family history were insignificant.The onset was insidious, with two months prior this admission, with progressive weakness to which weight loss (10 kg) and nonspecific upper abdominal pain were associated later.His physical examination revealed only hepatomegaly and splenomegaly.Laboratory studies indicated biological inflammatory syndrome (ESR, slightly elevated fibrinogen), hypergammaglobulinemia and a negative tuberculin purified protein derivative (PPD ) skin test.Abdominal ultrasound and CT scan documented multiple subdiaphragmatic lymph nodes (periaortic, inter-aorto-caval and iliac), with diameter from 1.75 to 2.5 cm (Figure 1).

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Section: Discussionmentioning

confidence: 99%

Unusual Presentation Of Sarcoidosis: Case Report

Tatiana

Mazilu

Crăciun

et al. 2017

ARS Medica Tomitana

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“…An important point is that new manifestation during sarcoidosis can be caused solely by sarcoidosis per se and/or other causes. The World Association for Sarcoidosis and Other Granulomatous Disorders recently published tools to use in visceral localisations [38,39]. We did not consider persistent disabling symptoms such as fatigue, small-fibre neuropathy, cognitive dysfunction, depression and impaired quality of life, which may be at the forefront for many patients with sarcoidosis [40][41][42][43][44][45].…”

Section: Discussionmentioning

confidence: 99%

Management of sarcoidosis in clinical practice

et al. 2016

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Sarcoidosis is a systemic disease of unknown cause with very diverse presentation, outcome, severity and need for treatments. While some presentations may be very typical, for many patients, the presentation is nonspecific, with shared associations with other diseases at times being by far more frequent or misleading, which can be a cause of significant delay and often several consultations before a diagnosis of sarcoidosis can be confirmed. This is particularly the case when pulmonary manifestations are in the forefront. The diagnosis relies on three well-known criteria. In clinical practice, these criteria are not easily implemented, particularly by physicians without expertise in sarcoidosis, which can lead to a risk of either under-or over-diagnosis. Qualifying the presentation according to sarcoidosis diagnosis is essential. However, it is often not easy to classify the presentation as typical versus compatible or compatible versus inconsistent. Further investigations are needed before any other hypothesis is to be considered. It is important to detect events and to determine whether or not they are indicative of a flare of sarcoidosis. Eventually, treatment needs to be related to the correct indications. The evaluation of the efficacy and safety of treatments is crucial. To address such issues, we present five emblematic cases that illustrate this. @ERSpublications Showing emblematic cases is the best way to illustrate the multiple conditions to deal with for managing sarcoidosis http://ow.ly/10A5Yv

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“…Hepatic sarcoid nodules are detected radiologically in 5%-50% of patients. The nodules are always multiple in number, ranging in size from 0.5 to 2 cm in diameter (2). However, in rare cases, hepatic sarcoid nodules can have a mass-like appearance imitating primary liver malignancy or metastasis, and it is difficult to distinguish hepatic sarcoidosis from malignancy or metastasis in these cases (6,7).…”

Section: Answermentioning

confidence: 99%

“…However, the length of treatment and the effectiveness on disease prognosis is unclear. Liver transplantation can be performed for patients with cirrhosis, although occasionally sarcoidosis may recur in the graft liver (2,8).…”

Section: Answermentioning

confidence: 99%

Multiple liver masses mimicking metastatic liver disease in an elderly patient

Köklü

Armağan

Karadağ

et al. 2018

Turk J Gastroenterol

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QUESTIONA 68-year-old male was admitted with complaints of weakness, mild right upper quadrant pain, and rightside wrist arthralgia. The medical history of the patient included hypertension and benign prostate hyperplasia, and his long-term medications were indapamide, doxazosin, alfuzosin, perindopril, and amlodipine. He also had a 20 pack-year smoking history and no history of alcohol intake. Physical examination findings were unremarkable except for tenderness in the right wrist. The laboratory test results showed hemoglobin: 8.4 g/dL (normal range [NR]: 13.6-17.2), white blood cell: 11. Negative test results were obtained for hepatitis-B surface antigen, hepatitis C antibody, antimitochondrial antibody, antinuclear antibody, rheumatoid factor, antineutrophil cytoplasmic antibodies, and quantiferon for tuberculosis. Serum angiotensin-converting enzyme (ACE), B2 microglobulin, and immunoglobulin G and M levels were within the NR. On dynamic abdominal computed tomography (CT) scan, multiple irregularly shaped, hypodense masses that were peripherally enhancing in the arterial phase were observed in all liver segments, the largest of which was 1.5 cm in size (Figure 1). Thoracic CT showed four nodules of millimetric size in the right lung parenchyma, and there was no mediastinal lymphadenopathy. Upper gastrointestinal endoscopy revealed antral gastritis, and colonoscopy revealed a polyp of millimetric size in the ascending colon. On further investigation, tests for leishmania, brucellosis, mycobacterium, aspergillus, toxoplasma, Epstein-Barr virus, and cytomegalovirus

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Extrapulmonary Sarcoidosis

Cited by 119 publications

References 145 publications

Unusual Presentation Of Sarcoidosis: Case Report

Unusual Presentation Of Sarcoidosis: Case Report

Management of sarcoidosis in clinical practice

Multiple liver masses mimicking metastatic liver disease in an elderly patient

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