“…The significant, bilateral pleural involvement at initial presentation in this case is atypical for pleural sarcoidosis, as is the worsening of pleural disease control despite immunomodulatory therapy ( Fig. 3 [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]). The vast majority of sarcoidosis-related PEs reported in the literature have been small and spontaneously resolve [ 16 ], whilst patients with larger symptomatic effusions have received corticosteroid therapy alone or in combination with hydroxychloroquine, with a good response (see Fig.…”
Section: Discussionmentioning
confidence: 77%
“…The vast majority of sarcoidosis-related PEs reported in the literature have been small and spontaneously resolve [ 16 ], whilst patients with larger symptomatic effusions have received corticosteroid therapy alone or in combination with hydroxychloroquine, with a good response (see Fig. 3 ) [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]. Fig.…”
Pleural involvement is rare in sarcoidosis. The presence of a large symptomatic effusion in a patient with sarcoidosis should therefore prompt further investigation for an alternate aetiology. Here we present a case of confirmed pleuro-parenchymal sarcoidosis. We discuss the important differential diagnoses and review the current literature.
“…The significant, bilateral pleural involvement at initial presentation in this case is atypical for pleural sarcoidosis, as is the worsening of pleural disease control despite immunomodulatory therapy ( Fig. 3 [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]). The vast majority of sarcoidosis-related PEs reported in the literature have been small and spontaneously resolve [ 16 ], whilst patients with larger symptomatic effusions have received corticosteroid therapy alone or in combination with hydroxychloroquine, with a good response (see Fig.…”
Section: Discussionmentioning
confidence: 77%
“…The vast majority of sarcoidosis-related PEs reported in the literature have been small and spontaneously resolve [ 16 ], whilst patients with larger symptomatic effusions have received corticosteroid therapy alone or in combination with hydroxychloroquine, with a good response (see Fig. 3 ) [ [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] ]. Fig.…”
Pleural involvement is rare in sarcoidosis. The presence of a large symptomatic effusion in a patient with sarcoidosis should therefore prompt further investigation for an alternate aetiology. Here we present a case of confirmed pleuro-parenchymal sarcoidosis. We discuss the important differential diagnoses and review the current literature.
“…HRCT is used to confirm CXR findings and can detect parenchymal abnormalities not evident on CXR. The most common radiologic findings of sarcoidosis on HRCT include lymphadenopathy, perilymphatic micronodules, interstitial thickening, and pulmonary fibrosis [20, 21]. Bilateral ground glass opacities are a rare finding of sarcoidosis.…”
Sarcoidosis is a systemic inflammatory disease characterized by the presence of noncaseating granulomas in different organs. Sarcoidosis associated with monoclonal gammopathy of undetermined significance (MGUS) is a rare finding with only 10 cases reported to date. We describe a 79-year-old male patient who presented with dry mouth for 4 months. Lip biopsy done prior to admission showed nonnecrotizing epithelioid cell granulomas. On admission, laboratory analysis was significant for elevated calcium, decreased parathyroid hormone, increased erythrocyte sedimentation rate, undetectable parathyroid hormone-related peptide (PTHrp), mildly decreased 25-hydroxyvitamin D, elevated 1,25-dihydroxyvitamin D, elevated angiotensin converting enzyme, and positive Bence Jones protein in the urine. Serum protein electrophoresis showed an elevated gamma globulin level at 38% and an IgG monoclonal gammopathy with an M-spike of 1.47. Bone marrow biopsy was consistent with MGUS. The patient showed significant improvement with steroids and was discharged with close follow-up from nephrology and oncology. Salivary gland involvement in patients with sarcoidosis is a rare finding. Our case is a valuable addition to the small number of cases described in the literature supporting an association between plasma cell disorders and sarcoidosis. Larger prospective studies are needed to determine if a true association between the two diseases exists.
Sarcoidosis is a chronic multisystemic inflammatory disease of unknown aetiology. Virtually any organ or system can be involved, resulting in a wide range of clinical presentation. Pleural sarcoidosis is rare. Pleural effusion can only be attributed to pleural sarcoidosis in the presence of pleural non-caseating epithelioid granulomas and after excluding other granulomatous diseases. Anthracosis is a pneumoconiosis associated with thoracic adenopathies and bronchial disease, and it is usually asymptomatic. The authors present a case of a middle-aged man hospitalized due to cough, right-sided pleuritic chest pain and trepopnoea.
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