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Published on: June 16, 2020
Life-threatening vasculitis associated with sarcoidosis
H Eid1, C R Oʼconnor, E Catalano
1Rheumatology Fellow (H.E.); Associate Professor of Clinical Medicine (C.R.O'C); Professor of Pathology, Chief of Pathology (E.C); Professor of Medicine, Head, Division of Rheumatology (A.J.R.), Cooper Hospital University Medical Center, Robert Wood Johnson Medical School, Camden, New Jersey.
Summary
Vasculitis, inflammation of blood vessels, can be a rare but severe complication in patients with sarcoidosis. This case highlights the importance of considering vasculitis in sarcoidosis patients, even during low-dose corticosteroid treatment.
Area of Science:
- Internal Medicine
- Rheumatology
- Neurology
Background:
- Sarcoidosis is a multisystem inflammatory disease.
- Vasculitis associated with sarcoidosis is uncommon.
- Corticosteroids are a common treatment for sarcoidosis.
Purpose of the Study:
- To report a rare case of severe vasculitis in a patient with sarcoidosis.
- To discuss the diagnostic and therapeutic challenges.
- To emphasize the importance of considering vasculitis in sarcoidosis management.
Main Methods:
- Case report and literature review.
- Clinical presentation and diagnostic workup.
- Treatment and outcome analysis.
Main Results:
- A young woman with a history of sarcoidosis developed leukocytoclastic and medium-size vessel vasculitis.
- The patient experienced hemorrhagic stroke, malignant hypertension, and limb gangrene requiring amputations.
- Severe vasculitis occurred despite low-dose corticosteroid therapy and in the absence of active sarcoidosis.
Conclusions:
- Vasculitis is an uncommon but potentially life-threatening complication of sarcoidosis.
- Vasculitis should be considered in sarcoidosis patients presenting with unexplained severe systemic symptoms.
- Early recognition and aggressive immunosuppressive therapy are crucial for managing severe vasculitis in sarcoidosis.
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