Bone loss in untreated longstanding sarcoidosis

The introduction of new techniques for the study of Bone Mineral Content (BMC) has not yet been extensively applied to sarcoidosis. Using Quantitative Computed Tomography (QCT) in a long-term prednisone-treated sarcoid population we have shown in 1988 [1] that Bone Mineral Loss is more frequent than elsewhere reported with other techniques on patients with different diseases. It was not clear if this difference was due to the sarcoidosis itself or to the better sensitivity of QCT compared to former techniques [2]. Thus we have now studied QCT in a group of 36 untreated patients with active, histologically proven sarcoidosis, chronic in most cases, to clarify the action of sarcoidosis itself over the BMC. For each patient Vertebral Cancellous Mineral Content (VCMC) has been expressed in terms of Z score (i.e. the number of Standard Deviations (SD) above or below the normal value) in order to overcome the differences due to age and sex. In the whole group, mean value of Z score was -0.41 +/- 0.30 (P > 0.05 vs. 190 normals). Nevertheless VCMC was below the normal range in 13 out of 36 patients; in five of them, all with longstanding sarcoidosis for at least 2 years, VCMC was more than two SD below the normal; four out of 36 had a VCMC lower than 110 mg/cm3 K2HPO4 eq, that is considered the threshold level under which the risk of fracture begins (but three of them were postmenopausal females).(ABSTRACT TRUNCATED AT 250 WORDS)