Multiple Bone Fractures Found in a Young Sarcoidosis Patient with Long Stable Disease

Abstract

A 22-year-old Japanese man was found to have bilateral hilar lymphadenopathy (BHL), and was diagnosed with sarcoidosis in 1995. He was followed without treatment until 2002, when a bone fracture due to osseous sarcoidosis was found in his left thumb. Despite systemic treatment with corticosteroid and methotrexate, a new bone lesion developed in his right foot and his right middle finger was fractured. The patient also suffered multiple organ involvements including brain and muscle lesions. This is the first report of a sarcoidosis patient who presented with BHL, and developed bone fractures after a long stable period of more than 5 years.

Sudden multiple fractures in a patient with sarcoidosis in multiple organs

“…Among these, racial diversity was noted, but people of African descent/origin (n=8) and Asian patients all of whom were Japanese (n=9) appear as prominent populations. Although few reports have described the racial incidence of bone fractures in patients with osseous sarcoidosis, Handa et al 3 indicated that people of African descent/origin tended to experience bone fractures, with no mention of Japanese cases. Our results suggest that the number of Japanese cases was equal to that of African descent/origin people.…”

Bilateral olecranon fracture as first presentation of sarcoidosis: Case report and review of the literature

“…5 Primarily, it occurs in patients with chronic sarcoidosis with multiple organ involvement. 4 The incidence of osseous involvement is low in patients with early-stage sarcoidosis and absence of cutaneous lesions. Sarcoidosis has a predilection for the bones of the hand and feet, and involvement of the long bones is rare.…”

“…Of these, 4 report bilateral osseous fractures of the same bone. 4,16,19,21 There is only 1 previous case of bilateral long bone fractures in a patient. 21 Bone lesions are more frequent in black patients.…”

Solitary osseous sarcoidosis: a rare reason for pathologic fracture

“…Osseous involvement, although sometimes painful, is usually asymptomatic [3]. Pathologic fracture caused by osseous sarcoidosis is extremely rare, and to the best of our knowledge, only 13 cases have been reported in literature [4]. Here, we report a case of which osseous sarcoidosis was the initial and major manifestation that eventually led to pathologic bone fracture.…”