Serum soluble interleukin‐2 receptor level is more sensitive than angiotensin‐converting enzyme or lysozyme for diagnosis of sarcoidosis and may be a marker of multiple organ involvement

Abstract

Skin lesions in sarcoidosis are often the initial symptoms that enable the dermatologist to be the first to diagnose this granulomatosis. However, diagnosis is sometimes very problematic. In 2015, the diagnostic criteria for sarcoidosis were updated in Japan, with elevated serum soluble interleukin-2 receptor (sIL-2R) replacing negative tuberculin reaction. Therefore, we assessed the clinical utility of sIL-2R compared with two other common markers, angiotensin-converting enzyme (ACE) and lysozyme, in patients who visited the dermatology clinic. Data from 72 patients showed that sIL-2R was more sensitive than both ACE and lysozyme in supporting a diagnosis of sarcoidosis (52.8%) compared with ACE (29%) and lysozyme (26.4%). Additionally, the sIL-2R level was significantly higher in patients with multiple organ involvement and parenchymal infiltration. Patients with elevated sIL-2R levels had higher serum ACE and lysozyme levels, a higher incidence of pulmonary involvement, more severe chest radiographic stage and a high incidence of expression-specific signs by imaging analysis. Receiver-operator curve analysis showed that sIL-2R was a better marker at the threshold cut-off point compared with ACE and lysozyme for identifying patients with multiple organ involvement, detecting patients with pulmonary disease and parenchymal infiltration as well as predicting the presence of specific signs in the diagnosis of sarcoidosis. Moreover, the kinetics of sIL-2R levels correlated closely with clinical manifestations, in contrast to the modest changes of ACE and lysozyme levels during the follow-up period. In conclusion, sIL-2R may be considered a good marker for diagnosis and a potential indicator of disease activity.

Clinical characteristics of sarcoidosis patients with systemic sclerosis‐specific autoantibody: Possible involvement of thymus and activation‐regulated chemokine and a review of the published works

“…In sarcoidosis, increased level of sIL‐2R in serum and bronchoalveolar lavage fluid (BALF) has been reported, and serum level of sIL‐2R was correlated with various indices of its disease severity, including ACE, radiographic stage of disease, 67 Ga scintigraphy uptake and CD4 + T lymphocyte number in BALF . We previously reported that sIL‐2R could be considered as a good marker in support of diagnosis and a potential indicator of disease activity . Interestingly, SSc patients were also reported to have high sIL‐2R levels in circulation .…”

“…The cut‐off value for CLEIA by using STACIA MEBLux test Scl‐70 or STACIA MEBLux test RNP was less than 10.0 U/mL for both. Complete medical histories, clinical examinations and laboratory tests were conducted for all patients at the first visit, as described previously . Skin lesions were assessed by biopsy; chest radiogram and high‐resolution computed tomography were used to assess pulmonary involvement, including bilateral hilar lymphadenopathy (BHL), parenchymal infiltrates or pulmonary fibrosis; and eye involvement, including uveitis, was evaluated by split‐lamp and funduscopic examination.…”

“…Complete medical histories, clinical examinations and laboratory tests were conducted for all patients at the first visit, as described previously. 21 Skin lesions were assessed by biopsy; chest radiogram and high-resolution computed tomography were used to assess pulmonary involvement, including bilateral hilar lymphadenopathy (BHL), parenchymal infiltrates or pulmonary fibrosis; and eye involvement, including uveitis, was evaluated by split-lamp and funduscopic examination. The panda sign, the lambda sign as well as other involved organs were examined by imaging with 18 F-fluorodeoxyglucose positron emission tomography and/or 67 Ga scintigraphy uptake.…”

Pulmonary sarcoidosis as a cause of intermittent fever of unknown origin in a hemodialysis patient with renal cell carcinoma: A case report and literature review

“…4 Recently, sIL-2R level has been reported to be a better marker for the diagnosis of sarcoidosis and the assessment of sarcoidosis activity than ACE and lysozyme. 17 Gallium-67 scintigraphy is used to identify the inflammatory areas and as an adjunctive tool in the diagnosis of sarcoidosis. 18 It is also useful for monitoring the effectiveness of steroid therapy.…”

Just a painful swelling of the ankles?

“…Elevated levels of angiotensin converting enzyme are often absent in Löfgren syndrome 5. Studies show that an elevated level of soluble IL-2 receptor is a more sensitive marker for diagnosis of sarcoidosis, and is an indicator of disease activity,9 but testing is not widely available. Chest radiography is often requested to look for hilar lymphadenopathy.…”