Bone marrow involvement in sarcoidosis: an elusive extrapulmonary manifestation

Peña-Garcia, Jorge Isaac; Shaikh, Sana; Barakoti, Bhishma; Papageorgiou, Christos D.; Lacasse, Alexandre

doi:10.1080/20009666.2019.1575688

Cited by 15 publications

(18 citation statements)

References 48 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Sarcoidosis is a rare inflammatory disease affecting about 10/100,000 people in the USA of all ages and ethnicities (5). The non-caseating granulomas that are the hallmark of the disease contain macrophages, multinucleated giant cells, and epithelioid cells.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Case Report: A Well-Hidden Cause for Myelopathy

et al. 2021

View full text Add to dashboard Cite

Introduction: Sarcoidosis is a rare, systemic inflammatory disease and can involve multiple organs, especially the lungs and lymph nodes. The nervous system is affected in <10 percent of patients, which is called neurosarcoidosis. Neurosarcoidosis can cause a multitude of symptoms and can mimic various diseases. A rare manifestation is bone marrow involvement. We describe a case of spinal cord syndrome due to myelopathy that was caused by sarcoidosis of the bone marrow.Case Presentation: A male patient presented to our hospital with incomplete spinal cord syndrome. He suffered from numbness of the legs which had progressed to severe paraparesis. Magnetic resonance imaging revealed thoracic myelopathy without contrast enhancement. Thorough diagnostics found no explanation for the myelopathy, and the patient was treated symptomatically with high-dose steroids. When the patient developed non-resolving leukopenia, a bone marrow biopsy was performed. The bone marrow showed changes due to sarcoidosis. Further testing revealed myocardial involvement of the sarcoidosis. The patient was started on oral prednisolone and methotrexate. Over the course of time, his symptoms improved, but he still suffers from spastic leg paresis and needs aids to walk farther than 1 kilometre.Conclusion: In patients presenting with neurological deficits of unknown cause, neurosarcoidosis is a potential explanation. If it manifests primarily in the bone marrow, the diagnosis can be easily overlooked. Abnormalities in a full blood count should make the treating physician consider this diagnosis, and a bone marrow biopsy should be performed.

show abstract

Section: Discussionmentioning

confidence: 99%

“…It occurs in all ages and can involve multiple organs, especially the lungs and lymph nodes (2,3). In <10 percent of patients, the nervous system is affected, which is called neurosarcoidosis (4)(5)(6). A rare manifestation is bone marrow involvement (7).…”

Section: Introductionmentioning

confidence: 99%

Case Report: A Well-Hidden Cause for Myelopathy

et al. 2021

View full text Add to dashboard Cite

show abstract

“…We identified differences in several analytes in the treated vs. untreated groups and in blacks compared to whites. A higher leukocyte count in treated sarcoidosis cases could reflect an appropriate response to therapy including improved hematopoiesis [47]. Leukopenia as a manifestation of sarcoidosis could be due to bone marrow involvement [48,49], hypersplenism [50], or lymphocyte redistribution.…”

Section: Discussionmentioning

confidence: 99%

Clinical characteristics and organ system involvement in sarcoidosis: comparison of the University of Minnesota Cohort with other cohorts

Perlman

Shenoy

et al. 2020

BMC Pulm Med

View full text Add to dashboard Cite

Background: Sarcoidosis is a systemic granulomatous disease of unknown etiology. Clinical cohort studies of different populations are important to understand the high variability in clinical presentation and disease course of sarcoidosis. The aim of the study is to evaluate clinical characteristics, including organ involvement, pulmonary function tests, and laboratory parameters, in a sarcoidosis cohort at the University of Minnesota. We compare the organ system involvement of this cohort with other available cohorts. Methods: We conducted a retrospective data collection and analysis of 187 subjects with biopsy-proven sarcoidosis seen at a tertiary center. Organ system involvement was determined using the WASOG sarcoidosis organ assessment instrument. Clinical phenotype groups were classified using the Genomic Research in Alpha-1 Antitrypsin Deficiency and Sarcoidosis criteria. Results: Mean subject age at diagnosis was 45.8 ± 12.4, with a higher proportion of males (55.1%), and a higher proportion of blacks (17.1%) compared to the racial distribution of Minnesota residents (5.95%). The majority (71.1%) of subjects required anti-inflammatory therapy for at least 1 month. Compared to the A Case Control Etiologic Study of Sarcoidosis cohort, there was a higher frequency of extra-thoracic lymph node (34.2% vs. 15.2%), eye (20.9% vs. 11.8%), liver (17.6% vs. 11.5%), spleen (20.9% vs. 6.7%), musculoskeletal (9.6% vs. 0.5%), and cardiac (10.7% vs. 2.3%) involvement in our cohort. A multisystem disease with at least five different organs involved was identified in 13.4% of subjects. A restrictive physiological pattern was observed in 21.6% of subjects, followed by an obstructive pattern in 17.3% and mixed obstructive and restrictive pattern in 2.2%. Almost half (49.2%) were Scadding stages II/III. Commonly employed disease activity markers, including soluble interleukin-2 receptor and angiotensin-converting enzyme, did not differ between treated and untreated groups.

show abstract

“…The second was a case of granulomatous lesions in the bone marrow, spleen, and abdominal lymph nodes without lung lesions [ 7 ]. The last was a case of granulomatous lesions in the lungs and bone marrow following development of cutaneous sarcoidosis [ 6 ]. On the other hand, although there has been a case report of renal dysfunction resulting in hypercalcemia due to bone marrow sarcoidosis [ 19 ], there have been no reports of cases of simultaneous glomerulonephritis and bone marrow sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

“…Although hepatic involvement is thought to occur in 50–90% of sarcoidosis patients [ 3 ], renal involvement is only observed in approximately 4–22% of cases [ 4 ]. Bone marrow involvement in sarcoidosis is also rare [ 5 , 6 ] (see Table 1 ).…”

Section: Introductionmentioning

confidence: 99%

A case of bone marrow involvement in sarcoidosis with crescentic glomerular lesions

Sugai

Murata

Oikawa

et al. 2020

Respiratory Medicine Case Reports

View full text Add to dashboard Cite

Renal and bone marrow involvements in sarcoidosis are rare. We experienced the case of a 67-year-old man with systemic sarcoidosis, with bone marrow involvement, hepatic involvement and a unique constellation of renal lesion with cellular crescent formation. Immunosuppressive therapy was helpful for maintaining the stability of his pancytopenia, hepatic function and renal function. To the best of our knowledge, the association between sarcoidosis, bone marrow involvement and crescentic glomerulonephritis has been reported in only few cases in literature.

show abstract

Bone marrow involvement in sarcoidosis: an elusive extrapulmonary manifestation

Cited by 15 publications

References 48 publications

Case Report: A Well-Hidden Cause for Myelopathy

Case Report: A Well-Hidden Cause for Myelopathy

Clinical characteristics and organ system involvement in sarcoidosis: comparison of the University of Minnesota Cohort with other cohorts

A case of bone marrow involvement in sarcoidosis with crescentic glomerular lesions

Contact Info

Product

Resources

About