Sarcoidosis associated with infliximab therapy in ulcerative colitis

Gîlcă, Georgiana-Emmanuela; Diaconescu, Smaranda; Balan, Gheorghe G.; Timofte, Oana; Ştefănescu, Gabriela

doi:10.1097/md.0000000000006156

Cited by 21 publications

(8 citation statements)

References 13 publications

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“…Oxidized LDL levels found in surgically excised stenotic valves are strongly correlated with the degree of inflammation and fibrocalcic remodelling of the valve [13,14]. Elevated systemic levels of lipoprotein (a) [Lp (a)] and oxidized phospholipids are also associated with AS and its progression [15,16]. Furthermore, it has recently been demonstrated that the LPA gene that codes for apolipoprotein (a) and determines Lp (a) levels is associated with the development and progression of calcific AS, in addition to being a risk factor for cardiovascular diseases [17,18].…”

Section: Resultsmentioning

confidence: 99%

The Impact of Valve Calcifications Upon the Haemodynamic Severity of Aortic Stenosis

Furnica¹,

Perianu²,

Oancea³

et al. 2020

Rev.Chim.

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The calcific aortic stenosis (AS) is characterized by progressive obstruction of the aortic valve opening and results from the action of several active cellular processes that lead to valve remodelling, promote fibrosis and valvular calcification. The purpose of the study is to assess the relationship between the severity of aortic valve calcifications quantified by the Agatston score density and the hemodynamic impact of aortic stenosis determined through Doppler echocardiography. The authors performed a retrospective analysis of 70 cases that benefited of transcatheter aortic valve implantation between January 2015-October 2019. All patients underwent cardiac computed tomography and comprehensive Doppler echocardiography prior to the procedure. The degree of calcification of aortic leaflets was quantified on non-contrast CT examinations in all cases using the Agatston score and its relationship with dynamic echocardiographic parameters was evaluated using specific statistical tests. Aortic valve Agatston score density showed a significant correlation with mean transvalvular gradient (R = 0,62, p<0.0001) same as age (R = 0.51, p = 0.036). These parameters together with sex, body mass index, body surface area, the status of arterial hypertension, dyslipidaemia, smoking, bicuspid aortic valve, history of coronary artery disease were introduced into a multivariate regression to identify independent predictors of the mean transvalvular gradient. Age (ß= -0.25, p = 0.003), aortic valve Agatston score density (ß =-0.63, p<0.001) and bicuspid aortic valve (ß = -0.32, p = 0,003) proved to be the only independent predictors of the haemodynamic severity of aortic stenosis. In conclusion, the degree of aortic valve calcifications is a strong indicator for the haemodynamic impact of AS. Cardiac computed tomography is a non-invasive and accurate method of evaluating aortic valve calcifications and could be used to grade the severity of AS in cases where echocardiographic findings are discordant. Keywords: transcatheter aortic valve implantation, leaflet calcification, hydroxyapatite, Agatston score, transvalvular gradient

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Section: Resultsmentioning

confidence: 99%

The Impact of Valve Calcifications Upon the Haemodynamic Severity of Aortic Stenosis

Furnica¹,

Perianu²,

Oancea³

et al. 2020

Rev.Chim.

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“…Four common categories of drugs that have been associated with the development of DISR are ICIs[ 2 - 4 ], HAART[ 5 - 7 ], IFNs[ 8 - 10 ], and TNF-α antagonists[ 11 - 13 ]. Also, several drugs such as BRAF[ 14 - 16 ] inhibitors, methotrexate and BCG have been associated with the development of syndromes indistinguishable from sarcoidosis, and are described as DISR.…”

Section: Discussionmentioning

confidence: 99%

Drug-induced sarcoidosis-like reaction three months after BNT162b2 mRNA COVID-19 vaccination: A case report and review of literature

Kim¹,

Kim²,

Fujii³

et al. 2023

World J Clin Cases

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BACKGROUND A 70-year-old man with hepatitis C virus-related recurrent hepatocellular carcinoma was admitted for further diagnosis of a 1 cm iso-hyperechoic nodule in segment (S) 5. CASE SUMMARY Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) revealed the nodule in S5 with a defect at the hepatobiliary phase, hyperintensity on diffusion weighted imaging (DWI) and hypointensity on apparent diffusion coefficient (ADC) map. Contrast-enhanced computed tomography revealed hypervascularity at the early phase, and delayed contrast-enhancement was observed at the late phase. Contrast-enhanced ultrasound (US) revealed incomplete defect at the late vascular phase. Inflammatory liver tumor, lymphoproliferative disease, intrahepatic cholangiocarcinoma (small duct type) and bile duct adenoma were suspected through the imaging studies. US guided biopsy, however, showed a noncaseating hepatic sarcoid-like epithelioid granuloma (HSEG), and histopathological analysis disclosed spindle shaped epithelioid cells harboring Langhans-type multinucleated giant cells. One month after admission, EOB-MRI signaled the disappearance of the defect at the hepatobiliary phase, of hyperintensity on DWI, of hypointensity on ADC map, and no stain at the early phase. CONCLUSION That the patient had received BNT162b2 messenger RNA (mRNA) coronavirus disease 2019 vaccination 3 mo before the occurrence of HSEG, and that its disappearance was confirmed 4 mo after mRNA vaccination suggested that the drug-induced sarcoidosis-like reaction (DISR) might be induced by the mRNA vaccination. Fortunately, rechallenge of drug-induced DISR with the third mRNA vaccination was not confirmed.

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“…In this setting, SLRs are referred to as Drug Induced Sarcoid-Like Reactions (DISR) [ 91 ]. Other therapies that can induce SLRs include antiretroviral drugs, adalimumab [ 92 ] and infliximab [ 93 ], which, paradoxically, are also potential therapies for sarcoidosis. The exact immunopathogenesis of DISR is currently unknown.…”

Section: Differential Diagnosismentioning

confidence: 99%

Pulmonary Sarcoidosis: Diagnosis and Differential Diagnosis

et al. 2021

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Sarcoidosis is a multisystem disorder of unknown origin and poorly understood pathogenesis that predominantly affects lungs and intrathoracic lymph nodes and is characterized by the presence of noncaseating granulomatous inflammation in involved organs. The disease is highly heterogeneous and can mimic a plethora of other disorders, making diagnosis a challenge even for experienced physicians. The evolution and severity of sarcoidosis are highly variable: many patients are asymptomatic and their disease course is generally benign with spontaneous resolution. However, up to one-third of patients develop chronic or progressive disease mainly due to pulmonary or cardiovascular complications that require long-term therapy. The diagnosis of sarcoidosis requires histopathological evidence of noncaseating granulomatous inflammation in one or more organs coupled with compatible clinical and radiological features and the exclusion of other causes of granulomatous inflammation; however, in the presence of typical disease manifestations such as Löfgren’s syndrome, Heerfordt’s syndrome, lupus pernio and asymptomatic bilateral and symmetrical hilar lymphadenopathy, the diagnosis can be established with high level of certainty on clinical grounds alone. This review critically examines the diagnostic approach to sarcoidosis and emphasizes the importance of a careful exclusion of alternative diagnoses.

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Sarcoidosis associated with infliximab therapy in ulcerative colitis

Cited by 21 publications

References 13 publications

The Impact of Valve Calcifications Upon the Haemodynamic Severity of Aortic Stenosis

The Impact of Valve Calcifications Upon the Haemodynamic Severity of Aortic Stenosis

Drug-induced sarcoidosis-like reaction three months after BNT162b2 mRNA COVID-19 vaccination: A case report and review of literature

Pulmonary Sarcoidosis: Diagnosis and Differential Diagnosis

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