Osteoarticular Involvement in a Series of 100 Patients with Sarcoidosis Referred to Rheumatology Departments

• Published in: Journal of rheumatology 2008-08, Vol.35 (8), p.1622-1628
• Main Authors: THELIER, Natacha, ASSOUS, Noémie, JOB-DESLANDRE, Chantal, MEYER, Olivier, BARDIN, Thomas, ORCEL, Philippe, LIOTE, Frédéric, DOUGADOS, Maxime, KAHAN, Andre, ALLANORE, Yannick
• Format: Article
• Language: English
• Subjects: Adult; Arthritis - complications; Biological and medical sciences; Cohort Studies; Diseases of the osteoarticular system; Female; Hospitalization; Humans; Joints - pathology; Lung Diseases, Interstitial - complications; Male; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Osteitis - complications; Osteitis - pathology; Retrospective Studies; Sarcoidosis - complications; Sarcoidosis - pathology; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Syndrome
• ISSN: 0315-162X; 1499-2752

Objective To analyze the pattern of osteoarticular lesions in patients with sarcoidosis hospitalized in 4 rheumatology departments. Methods We carried out a systematic retrospective analysis of cases with sarcoidosis admitted in the last 10 years, using hospital databases. Two distinct groups were defined from the outset: patients with Löfgren’s syndrome (LS) or sarcoid rheumatism (SR). We assessed the following items: distribution of arthritis, chronicity, systemic manifestations, biochemical and immunological measures. Results We included 100 patients (75% women); 43% had LS and 57% SR. Osteoarticular symptoms revealed the disease in 85% of patients. The patients in the LS group were younger than those in the SR group (41 ± 9 vs 48 ± 13 yrs; p < 0.006) and were more likely to have oligoarthritis involving ankles (58% vs 32%; p = 0.04) and high C-reactive protein concentrations (63% vs 33%; p < 0.005). Patients with SR presented osteoarticular symptoms in the form of oligoarthritis (32%), poly-arthritis (32%), bony erosion in 8/57 (14%), and osteitis in 9/57 (16%). Lung interstitial involvement was more frequent in the SR group than in the LS group (38% vs 18%; p = 0.03). Chronic poly-arthritis was associated with the detection of rheumatoid factor (p = 0.004). Osteitis occurred in older patients (p = 0.02). Conclusion SR was the most frequent manifestation leading to hospitalization; it was characterized by oligoarthritis and polyarthritis and associated with interstitial lung involvement. Osseous involvement occurred in a quarter of SR patients with similar frequency of erosions targeting the distal small bones and osteitis. These latter occurred at a later age. Key Indexing Terms: SARCOIDOSIS ARTHRITIS ARTHRALGIA BONE LOFGREN’S SYNDROME