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Arthritis in sarcoidosis.
V Govindarajan1, V Agarwal, A Aggarwal
1Department of Clinical Immunology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
Summary
Arthritis is a common early sign of sarcoidosis, often mimicking other conditions like reactive or rheumatoid arthritis. Chronic arthritis in sarcoidosis may require immunosuppressive drugs beyond steroids for effective management.
Area of Science:
- Rheumatology
- Immunology
- Systemic Inflammatory Diseases
Background:
- Sarcoidosis is a systemic granulomatous disease with diverse clinical presentations.
- Articular manifestations of sarcoidosis are underrepresented in medical literature.
- Understanding the spectrum of joint involvement in sarcoidosis is crucial for diagnosis and management.
Purpose of the Study:
- To retrospectively analyze the clinical characteristics of patients with sarcoidosis presenting with articular symptoms.
- To describe the different patterns of arthritis in sarcoidosis and their associated features.
- To evaluate treatment outcomes for acute and chronic arthritis in sarcoidosis.
Main Methods:
- Retrospective analysis of case records of patients diagnosed with sarcoidosis between 1990 and 1999.
- Inclusion criteria: patients presenting with articular symptoms.
- Data collected included demographics, clinical presentation, diagnostic methods (clinical or biopsy), duration of symptoms, and treatment response.
Main Results:
- Twenty-nine patients (15 males, 14 females) with a median age of 44 were studied.
- Arthritis was the presenting manifestation in 25 patients, with 15 experiencing chronic arthritis (>6 months).
- Acute arthritis (episodic, lower limb involvement) mimicked reactive arthritis, while chronic arthritis (hand joint involvement) resembled rheumatoid arthritis, with distinct extra-articular features observed in each group.
Conclusions:
- Arthritis is a significant early manifestation of sarcoidosis.
- Sarcoid arthritis can present in patterns mimicking reactive or rheumatoid arthritis, necessitating careful differential diagnosis.
- Chronic sarcoid arthritis often shows an unsatisfactory response to initial treatments, indicating a potential need for immunosuppressive therapies in addition to corticosteroids.