Sarcoidosis: Pitfalls and Challenging Mimickers

Narula, Naureen; Iannuzzi, Michael C.

doi:10.3389/fmed.2020.594275

Cited by 30 publications

(19 citation statements)

References 202 publications

(35 reference statements)

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“…Few studies have reported on antiphospholipid syndrome and their findings differed with respect to the presence of antiphospholipid antibodies (38% vs. 2–5%) in sarcoidosis patients [ 1 , 2 , 3 , 8 , 13 , 31 , 32 , 33 ]. It has been reported in the literature that the presence of antiphospholipid antibodies in sarcoidosis patients is correlated with a poor prognosis [ 8 , 13 , 31 , 32 , 33 ], and some authors state that these antibodies are disease markers with a prolonged course and are associated with extrathoracic involvement and persistence of radiographic changes [ 30 , 31 , 32 , 33 , 34 ].…”

Section: Discussionmentioning

confidence: 99%

“…Sarcoidosis is a frequently insidious, rare, multiorgan disease, and diagnosis is often a chance finding at a routine chest radiography, carried out for other reasons, typically observed in adolescents or young adults [ 1 , 2 ]. Lung involvement is common and symptoms may include cough, dyspnea and chest pain.…”

Section: Introductionmentioning

confidence: 99%

“…Extrapulmonary symptoms may involve the skin, joints and eyes. The chest radiograph typically evidence bilateral hilar adenopathy [ 1 , 2 , 3 , 4 ], and although there may be a rise in angiotensin converting enzyme levels, this finding is not diagnostic and histopathological confirmation of noncaseating granulomas is required to confirm diagnosis [ 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. This biopsy is usually obtained from the most peripheral site possible, although transbronchial biopsy is commonly required [ 1 , 2 , 3 , 4 , 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

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Correlation between Potential Risk Factors and Pulmonary Embolism in Sarcoidosis Patients Timely Treated

Ruaro

Confalonieri

Santagiuliana

et al. 2021

JCM

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Background. Some studies with inconclusive results have reported a link between sarcoidosis and an increased risk of pulmonary embolism (PE). This study aimed at assessing a possible correlation between potential risk factors and PE in sarcoidosis patients. Methods. A total of 256 sarcoidosis patients (84 males and 172 females; mean age at diagnosis 49 ± 13) were enrolled after giving written informed consent. Clinical evaluations, laboratory and radiology tests were performed to evaluate the presence of pulmonary embolism. Results. Fifteen sarcoidosis patients with PE (4 males and 11 females; mean age at diagnosis 50 ± 11), diagnosed by lung scintigraphy and 241 sarcoidosis patients without PE (80 males and 161 females; mean age at diagnosis 47 ± 13), were observed. There was a statistically significant increase of the presence of antiphospholipid antibodies in the sarcoidosis group with pulmonary embolism. There was no statistically significant difference between the two groups as to smoking habit, obesity or hereditary thrombophilia frequency (p > 0.05, respectively). Conclusions. This study demonstrates a significant correlation between the presence of antiphospholipid antibody positivity and the pulmonary embolism events in our sarcoidosis patients. Furthermore, we propose screening for these antibodies and monitoring, aimed at timely treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correlation between Potential Risk Factors and Pulmonary Embolism in Sarcoidosis Patients Timely Treated

Ruaro

Confalonieri

Santagiuliana

et al. 2021

JCM

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“…Siblings and offspring of subjects suffering from S are five and four times more likely to develop the disease, respectively [ 75 , 76 , 77 , 78 ]. Different HLA second class (HLA-DR) alleles have been detected to be S-related [ 79 , 80 , 81 , 82 , 83 , 84 , 85 , 86 , 87 , 88 , 89 ]: HLA DRB1*15 in the Turkish population [ 90 ]; HLADRB1*11 in subjects with extra-pulmonary S [ 91 ]; HLA DRB1*0401 in patients suffering from OS involvement [ 92 ].…”

Section: Literature Reviewmentioning

confidence: 99%

Sarcoid Uveitis: An Intriguing Challenger

Allegri¹,

Olivari²,

Rissotto

et al. 2022

Medicina

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The purpose of our work is to describe the actual knowledge concerning etiopathogenesis, clinical manifestations, diagnostic procedures, complications and therapy of ocular sarcoidosis (OS). The study is based on a recent literature review and on the experience of our tertiary referral center. Data were retrospectively analyzed from the electronic medical records of 235 patients (461 eyes) suffering from a biopsy-proven ocular sarcoidosis. Middle-aged females presenting bilateral ocular involvement are mainly affected; eye involvement at onset is present in one-third of subjects. Uveitis subtype presentation ranges widely among different studies: panuveitis and multiple chorioretinal granulomas, retinal segmental vasculitis, intermediate uveitis and vitreitis, anterior uveitis with granulomatous mutton-fat keratic precipitates, iris nodules, and synechiae are the main ocular features. The most important complications are cataract, glaucoma, cystoid macular edema (CME), and epiretinal membrane. Therapy is based on the disease localization and the severity of systemic or ocular involvement. Local, intravitreal, or systemic steroids are the mainstay of treatment; refractory or partially responsive disease has to be treated with conventional and biologic immunosuppressants. In conclusion, we summarize the current knowledge and assessment of ophthalmological inflammatory manifestations (mainly uveitis) of OS, which permit an early diagnostic assay and a prompt treatment.

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“…It is important to state, however, that both features may be absent. In such cases, a positive Interferon-gamma release assay (IGRA) or tuberculin skin test (TST) associated with a positive PCR on clinical specimens generally suggest the correct diagnosis [ 71 ]. Rarely (<1% of cases), sarcoidosis may mimic miliary TB, with diffuse micronodules randomly disseminated in both lungs [ 72 ].…”

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: Pitfalls and Challenging Mimickers

Cited by 30 publications

References 202 publications

Correlation between Potential Risk Factors and Pulmonary Embolism in Sarcoidosis Patients Timely Treated

Correlation between Potential Risk Factors and Pulmonary Embolism in Sarcoidosis Patients Timely Treated

Sarcoid Uveitis: An Intriguing Challenger

Pulmonary Sarcoidosis: Diagnosis and Differential Diagnosis

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