Arthritis in sarcoidosis: A multicentric study from India

Agarwal, Vikas; Agrawal, Vinita; Aggarwal, Amita; Aggarwal, Parshant; Chowdhury, Abhra Chandra; Ghosh, Parasar; Jain, Avinash; Lawrence, Able; Misra, Durga Prasanna; Mohapatra, Madhusmita Mohanty; Nath, Alok; Negi, Vir Singh; Pandya, Sapan; Reddy, V.U.; Prasad, Shiva; Sharma, Aman; Shobha, Vineeta; Singh, Yogesh Preet; Tripathy, Saumya Ranjan; Wakhlu, Anupam

doi:10.1111/1756-185x.13349

Cited by 14 publications

(5 citation statements)

References 23 publications

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“…Resolution of the inflammatory arthritis usually occurs within 6 weeks in most patients and within 2 years in almost all patients 20, 28, 29. Enthesitis (especially Achilles tendinitis) can also be found in patients with sarcoid arthropathy; the prevalence is about 5% to 8% 28, 30…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Clinical Manifestations, Diagnosis, and Treatment of Sarcoidosis

Ungprasert

Ryu

Matteson

2019

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

222

192

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The focus of this review is current knowledge about the epidemiology, clinical manifestations, diagnosis, and treatment of both pulmonary sarcoidosis and extrapulmonary sarcoidosis. Although intrathoracic involvement is the hallmark of the disease, present in over 90% of patients, sarcoidosis can affect virtually any organ. Clinical presentations of sarcoidosis are diverse, ranging from asymptomatic, incidental findings to organ failure. Diagnosis requires the presence of noncaseating granuloma and compatible presentations after exclusion of other identifiable causes. Spontaneous remission is frequent, so treatment is not always indicated unless the disease is symptomatic or causes progressive organ damage/dysfunction. Glucocorticoids are the cornerstone of treatment of sarcoidosis even though evidence from randomized controlled studies is lacking. Glucocorticoid-sparing agents and biologic agents are often used as second- and third-line therapy for patients who do not respond to glucocorticoids or experience serious adverse effects.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Clinical Manifestations, Diagnosis, and Treatment of Sarcoidosis

Ungprasert

Ryu

Matteson

2019

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

222

192

View full text Add to dashboard Cite

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“…1 ) shows the inclusion process. We obtained 41 articles in full text and included 11 articles [ 4 , 17 – 26 ], which are listed in Table 1 . One article [ 53 ] was in Spanish and was therefore excluded.…”

Section: Resultsmentioning

confidence: 99%

“…In most cases, the respiratory system is involved [ 3 ], other affected organ systems are skin, eyes, and systemic symptoms, such as fever, night sweats, fatigue, and malaise. Within the musculoskeletal system, ankles, knees and wrists are the most commonly involved joints, with oligo-articular involvement more prominent in acute arthritis [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Sarcoidosis with musculoskeletal manifestations: systematic review of non-pharmacological and pharmacological treatments

2022

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We aimed to summarise effects and use of non-pharmacological and pharmacological treatments for sarcoidosis with musculoskeletal manifestations. We systematically searched the Cochrane Library, Ovid MEDLINE, Embase, CINAHL, AMED, Scopus, clinical.trials.gov, PROSPERO and PEDro for systematic reviews from 2014 to 2022 and for primary studies from date of inception to March 29, 2022, and studies with patients diagnosed with sarcoidosis with musculoskeletal manifestations. Inclusion criteria required that studies reported effects of non-pharmacological and/or pharmacological treatments or number of patients receiving these treatments. Results were reported narratively and in forest plots. Eleven studies were included. No systematic reviews fulfilled our inclusion criteria. None of the included studies had a control group. We found that between 23 and 100% received corticosteroids, 0–100% received NSAIDs, 5–100% received hydroxychloroquine, 12–100% received methotrexate, 0–100% received TNF inhibitors, and 3–4% received azathioprine. Only ten patients in one study had used non-pharmacological treatments, including occupational therapy, chiropractic and acupuncture. There are no controlled studies on treatment effects for patients with sarcoidosis with musculoskeletal manifestations. We found 11 studies reporting use of pharmacological treatments and only one study reporting use of non-pharmacological treatments. Our study identified major research gaps for pharmacological and non-pharmacological treatment in musculoskeletal sarcoidosis and warrant randomised clinical trials for both.

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“…Usually, acute sarcoid arthropathy presents as part of Lofgren’s syndrome, characterized by the triad of bilateral hilar adenopathy, migratory polyarthralgia, and erythema nodosum. Radiographic findings include cystic or sclerotic lesions and a lacy pattern of multiple lesions [ 5 - 8 ]. Our patient’s symptoms were not typical of sarcoid arthropathy; her clinical presentation, inflammatory arthropathy on SFA, and chondrocalcinosis on knee imaging were suggestive of CPPD despite SFA that was negative for crystals.…”

Section: Discussionmentioning

confidence: 99%

Acute inflammatory arthropathy and hypercalcemia leading to a diagnosis of primary hyperparathyroidism in a patient with known sarcoidosis

Larsen,

Guma,

Mehannek

et al. 2023

Cureus

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Calcium pyrophosphate deposition disease (CPPD) is a crystal-induced arthropathy characterized by calcium pyrophosphate crystal deposition in joints and soft tissues. The diagnosis is suggested by the presence of chondrocalcinosis on x-ray but is most often diagnosed by synovial fluid analysis (SFA). CPPD is associated with aging and metabolic disorders such as hyperparathyroidism. In this case, we present an 87-year-old woman with known sarcoidosis who presented with acute arthropathy, hypercalcemia, and radiographic evidence of CPPD. Her hypercalcemia had been attributed to her sarcoidosis in the past without a full workup. Hypercalcemia in the setting of suspected CPPD led to a full workup for hypercalcemia and ultimately led to a diagnosis of primary hyperparathyroidism. This case highlights the importance of a complete evaluation for hypercalcemia in the setting of CPPD, even when another disease, such as sarcoidosis, could explain hypercalcemia. Ultimately, CPPD aided in diagnosing hyperparathyroidism in our patient with known sarcoidosis.

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Arthritis in sarcoidosis: A multicentric study from India

Cited by 14 publications

References 23 publications

Clinical Manifestations, Diagnosis, and Treatment of Sarcoidosis

Clinical Manifestations, Diagnosis, and Treatment of Sarcoidosis

Sarcoidosis with musculoskeletal manifestations: systematic review of non-pharmacological and pharmacological treatments

Acute inflammatory arthropathy and hypercalcemia leading to a diagnosis of primary hyperparathyroidism in a patient with known sarcoidosis

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