Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis?
Background: Sarcoidosis is a multisystem granulomatous disease. Co-existence with spondyloarthritis (SA) has been more described as an adverse effect of anti-TNF α therapy than an association. We report herein a case of a typical sarcoidosis confirmed by histological proofs and an advanced SA with a...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Babol University of Medical Sciences
2018-01-01
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| Series: | Caspian Journal of Internal Medicine |
| Subjects: | |
| Online Access: | http://caspjim.com/browse.php?a_code=A-10-613-2&slc_lang=en&sid=1 |
| _version_ | 1819093414074908672 |
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| author | Wafa Hamdi Saoussen Miladi Dhia Kaffel Imen Zouch Med Montacer Kchir |
| author_facet | Wafa Hamdi Saoussen Miladi Dhia Kaffel Imen Zouch Med Montacer Kchir |
| author_sort | Wafa Hamdi |
| collection | DOAJ |
| description | Background: Sarcoidosis is a multisystem granulomatous disease. Co-existence with spondyloarthritis (SA) has been more described as an adverse effect of anti-TNF α therapy than an association. We report herein a case of a typical sarcoidosis confirmed by histological proofs and an advanced SA with a bamboo column.
Case Presentation: A 48-years-old woman presented with inflammatory back pain for 5 years and ankle swelling for 1 year. On physical examination, she had an exaggerated dorsal kyphosis and disappearance of lumbar lordosis with limitation in motion of the cervical and lumbar spine. Laboratory tests did not show an inflammatory syndrome or hypercalcemia. Plain radiographies of the spine and pelvic revealed a triple ray appearance with sacroiliitis grade 4. Chest radiography and CT confirmed the presence of bilateral hilar lymph nodes and parenchymal nodes. Bronchoscopy and biopsies were performed showing non-calcified granulomatous reaction without cell necrosis. The diagnosis of SA was performed based on 9 points of Amor criteria associated with pulmonary sarcoidosis. She was treated with 15 mg per week of methotrexate and 1mg/kg/day of prednisone for pulmonary disease with good outcomes.
Conclusions: Sarcoidosis may be associated to SA besides paradoxical drug effect. The same physio pathological pathways mediate by TNF α are arguments for association than hazardous coincidence |
| first_indexed | 2024-12-21T23:11:08Z |
| format | Article |
| id | doaj.art-02b24fc965094812a93692df96dd8ae2 |
| institution | Directory Open Access Journal |
| issn | 2008-6164 2008-6172 |
| language | English |
| last_indexed | 2024-12-21T23:11:08Z |
| publishDate | 2018-01-01 |
| publisher | Babol University of Medical Sciences |
| record_format | Article |
| series | Caspian Journal of Internal Medicine |
| spelling | doaj.art-02b24fc965094812a93692df96dd8ae22022-12-21T18:47:02ZengBabol University of Medical SciencesCaspian Journal of Internal Medicine2008-61642008-61722018-01-0191100103Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis?Wafa Hamdi0Saoussen Miladi1Dhia Kaffel2Imen Zouch3Med Montacer Kchir4 Department of Rheumatology, Kassab Institute of Orthopedics, Manouba, Tunisia Department of Rheumatology, Kassab Institute of Orthopedics, Manouba, Tunisia Department of Rheumatology, Kassab Institute of Orthopedics, Manouba, Tunisia Department of Rheumatology, Kassab Institute of Orthopedics, Manouba, Tunisia Department of Rheumatology, Kassab Institute of Orthopedics, Manouba, Tunisia Background: Sarcoidosis is a multisystem granulomatous disease. Co-existence with spondyloarthritis (SA) has been more described as an adverse effect of anti-TNF α therapy than an association. We report herein a case of a typical sarcoidosis confirmed by histological proofs and an advanced SA with a bamboo column. Case Presentation: A 48-years-old woman presented with inflammatory back pain for 5 years and ankle swelling for 1 year. On physical examination, she had an exaggerated dorsal kyphosis and disappearance of lumbar lordosis with limitation in motion of the cervical and lumbar spine. Laboratory tests did not show an inflammatory syndrome or hypercalcemia. Plain radiographies of the spine and pelvic revealed a triple ray appearance with sacroiliitis grade 4. Chest radiography and CT confirmed the presence of bilateral hilar lymph nodes and parenchymal nodes. Bronchoscopy and biopsies were performed showing non-calcified granulomatous reaction without cell necrosis. The diagnosis of SA was performed based on 9 points of Amor criteria associated with pulmonary sarcoidosis. She was treated with 15 mg per week of methotrexate and 1mg/kg/day of prednisone for pulmonary disease with good outcomes. Conclusions: Sarcoidosis may be associated to SA besides paradoxical drug effect. The same physio pathological pathways mediate by TNF α are arguments for association than hazardous coincidencehttp://caspjim.com/browse.php?a_code=A-10-613-2&slc_lang=en&sid=1SarcoidosisAnkylosing SpondylarthritisTumor Necrosis Factor Alpha |
| spellingShingle | Wafa Hamdi Saoussen Miladi Dhia Kaffel Imen Zouch Med Montacer Kchir Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis? Caspian Journal of Internal Medicine Sarcoidosis Ankylosing Spondylarthritis Tumor Necrosis Factor Alpha |
| title | Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis? |
| title_full | Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis? |
| title_fullStr | Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis? |
| title_full_unstemmed | Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis? |
| title_short | Sarcoidosis and spondyloarthritis: A coincidence or common etiopathogenesis? |
| title_sort | sarcoidosis and spondyloarthritis a coincidence or common etiopathogenesis |
| topic | Sarcoidosis Ankylosing Spondylarthritis Tumor Necrosis Factor Alpha |
| url | http://caspjim.com/browse.php?a_code=A-10-613-2&slc_lang=en&sid=1 |
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