Clinical features and prognostic significance of splenic involvement in sarcoidosis

Tetikkurt, Cuneyt; Pehlivan, Metin; Bilir, Muammer

doi:10.4081/monaldi.2017.893

Cited by 35 publications

(13 citation statements)

References 16 publications

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“…The kinetic chain of events of granuloma formation, evolution, and distribution is the hallmark for the prognostic outcome of sarcoidosis patients. The inconsistent propensity of granuloma formation and dissemination is the foremost pathologic mechanism liable for the differences of prognosis and organ involvement between individual patients [32][33][34]. Our study reveals that the transformation of the granuloma burden is the most distinctive marker of sarcoidosis outcome while the impact grade or the intensity of infl uence of granuloma burden for each organ is uncertain.…”

Section: Discussionmentioning

confidence: 91%

Clinical features and the prognostic significance of ocular sarcoidosis

Tetikkurt¹

2018

Arch Pulmonol Respir Care

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The main objective of this study was to evaluate the clinical features of ocular sarcoidosis. The second aim was to assess the infl uence of eye involvement on the prognostic outcome, extrapulmonary organ, and endobronchial involvement in sarcoidosis patients. Third objective was to determine the contribution of ocular involvement to fi nal diagnosis in patients presenting with an equivocal sarcoidosis diagnosis due to single organ disease. One hundred seventy two sarcoidosis patients paticipated in the study and were classifi ed into two groups according to the existence of eye involvement. The patients were evaluated retrospectively in regard to clinical features, prognostic outcome, extensity of extrapulmonary organ, and endobronchial involvement between the two groups. Eighty patients (46.5%) had eye sarcoidosis. Ocular involvement was the initial symptom in 15 subjects (18.7%) while asymptomatic ocular sarcoidosis was observed in 14 patients (17.5%) at initial admission. Red eye was the most common symptom occuring in 26 patients (32.8%) while anterior uveitis was the most frequent site (38.4%) of involvement. The other relevant ocular structures in the order of decreasing frequency were posterior uvea, papilla, lacrimal gland, and sclera. Patients with ocular sarcoidosis had a worse prognosis and a more extensive extrapulmonary organ involvement than the patients without eye disease. Although endobronchial involvement was more common in these patients, it was not statistically signifi cant. In 12 patients (15%) with an equivocal sarcoidosis, identifi cation of eye involvement confi rmed the fi nal diagnosis. The results of our study reveal that the identifi cation of ocular sarcoidosis appears to be a useful decisive clinical marker for determining the prognostic outcome of sarcoidosis patients. The incidence of extrapulmonary organ involvement was signifi cantly higher in patients with ocular sarcoidosis. Detection of ocular disease was also useful for the fi nal diagnosis in patients with a single organ sarcoidosis manifesting an indecisive clinical presentation. Recognition of ocular sarcoidosis is a rewarding and a preliminary clinical utility in sarcoidosis both for diagnosis and disease outcome while this fi nding may be an evidence of endobronchial involvement.

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Section: Discussionmentioning

confidence: 91%

Clinical features and the prognostic significance of ocular sarcoidosis

Tetikkurt¹

2018

Arch Pulmonol Respir Care

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“…Furthermore, the ACE levels had very good diagnostic value in patients with active sarcoidosis (sensitivity: 0.85; specificity: 0.718). There has been controversy concerning the role of serum ACE as a diagnostic and activity marker for sarcoidosis [ 11 , 15 , 21 , 22 , 29 , 30 , 31 , 32 , 33 ]. While there are several studies demonstrating that serum ACE levels are elevated in active sarcoidosis, the serum ACE levels were not significantly different between active and inactive sarcoidosis [ 11 , 15 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

“…Sarcoidosis is a systemic disease characterized by noncasefied granulomas in various organs. Serum ACE was also higher in patients with diffuse splenic involvement in sarcoidosis [ 33 ]. Thus, measuring serum levels of ACE may be helpful for monitoring the disease activity of sarcoidosis.…”

Section: Discussionmentioning

confidence: 99%

YKL-40, Soluble IL-2 Receptor, Angiotensin Converting Enzyme and C-Reactive Protein: Comparison of Markers of Sarcoidosis Activity

et al. 2018

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The aims of this study were to describe the clinical, radiological and immunological features of a population of sarcoidosis patients and to analyse chitinase-3-like protein 1 (YKL-40), soluble interleukin-2 receptor (sIL-2R), neopterin concentrations and adenosine deaminase (ADA) activity in serum of these patients in order to understand their potential as disease markers. Fifty-nine patients affected by chronic sarcoidosis, in active (20 patients) and inactive (39 patients) phase according to the clinical, radiological and laboratory criteria were studied. Serum YKL-40, sIL-2R, high-sensitive C-reactive protein (hs-CRP), neopterin levels and ADA activities were evaluated and compared with those of 25 healthy controls. Individuals with chronic sarcoidosis were significantly higher serum YKL-40, sIL-2R, neopterin, hs-CRP concentrations, angiotensin converting enzyme (ACE) and ADA activity than those of control subjects. Sarcoidosis patients in the active phase of the disease were significantly higher YKL-40, sIL-2R, hs-CRP levels and ACE activity than those in the inactive phase, while ADA activities and neopterin levels did not display any significant difference between the active and inactive disease groups. In comparison to the other parameters, as panel measurement of the serum YKL-40, sIL-2R, ACE and hs-CRP indicate a greater discrimination between active and inactive disease. The results indicate that serum YKL-40, sIL-2R, ACE and hs-CRP concentrations may be useful marker for monitoring sarcoidosis disease activity.

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“…Splenic involvement has been documented in 24 to 59% of patients with sarcoidosis undergoing routine fine needle aspiration splenic biopsies 125,126 but is usually asymptomatic. 126 Only 5 to 9% of patients with sarcoidosis have symptoms related to splenic involvement. 126 Splenic involvement can be documented by ultrasound, 127 CT, 122 or MRI scans.…”

Section: Spleenmentioning

confidence: 99%

“…126 Only 5 to 9% of patients with sarcoidosis have symptoms related to splenic involvement. 126 Splenic involvement can be documented by ultrasound, 127 CT, 122 or MRI scans. 123,126 Multiple low attenuation lesions typically range in size from 0.5 to 1.5 cm on CT or MRI, generally without enhancement 123 (►Figs.…”

Section: Spleenmentioning

confidence: 99%

Radiographic and Histopathologic Features in Sarcoidosis: A Pictorial Display

Shaikh

Abtin

Saggar

et al. 2020

Semin Respir Crit Care Med

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Sarcoidosis is a multisystemic granulomatous disorder that can affect virtually any organ. However, pulmonary and thoracic lymph node involvement predominates; abnormalities on chest radiographs are present in 80 to 90% of patients with sarcoidosis. High-resolution computed tomographic (HRCT) scans are superior to chest X-rays in assessing extent of disease, and some CT features may discriminate an active inflammatory component (which may be amenable to therapy) from fibrosis (for which therapy is not indicated). Typical findings on HRCT include micronodules, perilymphatic and bronchocentric distribution, perihilar opacities, and varying degrees of fibrosis. Less common findings on CT include mass-like or alveolar opacities, miliary opacities, mosaic attenuation, honeycomb cysts, and cavitation. With progressive disease, fibrosis, architectural distortion, upper lobe volume loss with hilar retraction, coarse linear bands, cysts, and bullae may be observed. We discuss the salient CT findings in patients with sarcoidosis (with a major focus on pulmonary features) and present classical radiographic and histopathological images of a few extrapulmonary sites.

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Clinical features and prognostic significance of splenic involvement in sarcoidosis

Cited by 35 publications

References 16 publications

Clinical features and the prognostic significance of ocular sarcoidosis

Clinical features and the prognostic significance of ocular sarcoidosis

YKL-40, Soluble IL-2 Receptor, Angiotensin Converting Enzyme and C-Reactive Protein: Comparison of Markers of Sarcoidosis Activity

Radiographic and Histopathologic Features in Sarcoidosis: A Pictorial Display

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