Sarcoidosis beyond pulmonary involvement: A case series of unusual presentations
Unusual presentations of sarcoidosis pose a diagnostic challenge and warrant attention. Hematologic associations: Case 1 (37-years-old male): Pancytopenia: myelofibrosis (leading to sepsis and mortality) following a two-year quiescent course of biopsy-proven-sarcoidosis. Case 2: (38-years-old male):...
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| Format: | Article |
| Language: | English |
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Elsevier
2021-01-01
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| Series: | Respiratory Medicine Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S221300712100157X |
| _version_ | 1819176784622518272 |
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| author | Basma M. Medhat Mervat E. Behiry Mohamed Fateen Nehal El-Ghobashy Raghda Fouda Aya Embaby Esraa M. Seif Marwa Magdy Taha Mohammed Kamal Hasswa Dina Sobhy Christina Samir Ragheb Mohamed Abdelkader Morad |
| author_facet | Basma M. Medhat Mervat E. Behiry Mohamed Fateen Nehal El-Ghobashy Raghda Fouda Aya Embaby Esraa M. Seif Marwa Magdy Taha Mohammed Kamal Hasswa Dina Sobhy Christina Samir Ragheb Mohamed Abdelkader Morad |
| author_sort | Basma M. Medhat |
| collection | DOAJ |
| description | Unusual presentations of sarcoidosis pose a diagnostic challenge and warrant attention. Hematologic associations: Case 1 (37-years-old male): Pancytopenia: myelofibrosis (leading to sepsis and mortality) following a two-year quiescent course of biopsy-proven-sarcoidosis. Case 2: (38-years-old male): Presentation with thrombocytopenia (5 × 103/cmm): immune thrombocytopenic purpura (histologically associated with megakaryocytic emperipolesis). Biopsied enlarged lymph nodes demonstrated sarcoidosis. Hematologic sarcoid involvement is usually due to granulomatous bone marrow (3.9%) or splenic infiltration (6–30%); however, the presented manifestations are scarcely reported with a potential significance that is yet to be elucidated. Case 3: Neurologic presentation: 48-years-old female: presentation with bilateral sensorineural hearing loss and facial palsy. Brain magnetic resonance imaging showed leptomeningeal thickening. Biopsied enlarged lymph nodes showed sarcoidosis. Case 4: Neurologic and renal manifestations: 13-years-old male (family history of sarcoidosis): Presenting with acute headache, investigations showed elevated serum creatinine (2.1 mg/dL) and angiotensin converting enzyme, and computed tomography chest and abdominal findings characteristic of sarcoidosis. Associated benign increased intracranial and acute tubulointerstitial nephritis (with eosinophils) were diagnosed upon concordant workup. Of sarcoidosis neurologic affection (5–10%), cranial nerve(s) involvement is among the most common (25–50% of neurosarcoid affection), particularly that of the facial nerve (Case 3). Leptomeningeal enhancement is among the most common neurosarcoid radiologic findings (30–40%). Whereas benign increased intracranial tension (Case 4) is much less reported. Among sarcoidosis renal involvement (35–50%), interstitial nephritis usually presents with granulomatous renal lesions, yet its sole association with sarcoidosis is unusual (Case 4). The portrayed atypical hematologic, neurologic, and renal manifestations further emphasize the masquerading nature of sarcoidosis. |
| first_indexed | 2024-12-22T21:16:16Z |
| format | Article |
| id | doaj.art-645e7b0792d1428aa0125d5e13c34f33 |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-12-22T21:16:16Z |
| publishDate | 2021-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-645e7b0792d1428aa0125d5e13c34f332022-12-21T18:12:20ZengElsevierRespiratory Medicine Case Reports2213-00712021-01-0134101495Sarcoidosis beyond pulmonary involvement: A case series of unusual presentationsBasma M. Medhat0Mervat E. Behiry1Mohamed Fateen2Nehal El-Ghobashy3Raghda Fouda4Aya Embaby5Esraa M. Seif6Marwa Magdy Taha7Mohammed Kamal Hasswa8Dina Sobhy9Christina Samir Ragheb10Mohamed Abdelkader Morad11Rheumatology and Rehabilitation Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; Corresponding author. Basma M Medhat Rheumatology and Rehabilitation Department, Kasr Alainy Faculty of Medicine, Cairo University, Kasr Alainy St., Cairo, 11562, Egypt.Rheumatology Unit. Internal Medicine Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, Egypt; Armed Forces College of Medicine (AFCM), Cairo, EgyptClinical and Chemical Pathology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptRheumatology and Rehabilitation Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptClinical and Chemical Pathology Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptRheumatology and Rehabilitation Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptRheumatology and Rehabilitation Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptRheumatology and Rehabilitation Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptChest Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptChest Department, Kasr Alainy Faculty of Medicine, Cairo University, Cairo, EgyptResident of Internal Medicine. Master's Degree of Internal Medicine, EgyptClinical Haematology Unit. Internal Medicine Department Kasr Alainy, Faculty of Medicine, Cairo University, Cairo, EgyptUnusual presentations of sarcoidosis pose a diagnostic challenge and warrant attention. Hematologic associations: Case 1 (37-years-old male): Pancytopenia: myelofibrosis (leading to sepsis and mortality) following a two-year quiescent course of biopsy-proven-sarcoidosis. Case 2: (38-years-old male): Presentation with thrombocytopenia (5 × 103/cmm): immune thrombocytopenic purpura (histologically associated with megakaryocytic emperipolesis). Biopsied enlarged lymph nodes demonstrated sarcoidosis. Hematologic sarcoid involvement is usually due to granulomatous bone marrow (3.9%) or splenic infiltration (6–30%); however, the presented manifestations are scarcely reported with a potential significance that is yet to be elucidated. Case 3: Neurologic presentation: 48-years-old female: presentation with bilateral sensorineural hearing loss and facial palsy. Brain magnetic resonance imaging showed leptomeningeal thickening. Biopsied enlarged lymph nodes showed sarcoidosis. Case 4: Neurologic and renal manifestations: 13-years-old male (family history of sarcoidosis): Presenting with acute headache, investigations showed elevated serum creatinine (2.1 mg/dL) and angiotensin converting enzyme, and computed tomography chest and abdominal findings characteristic of sarcoidosis. Associated benign increased intracranial and acute tubulointerstitial nephritis (with eosinophils) were diagnosed upon concordant workup. Of sarcoidosis neurologic affection (5–10%), cranial nerve(s) involvement is among the most common (25–50% of neurosarcoid affection), particularly that of the facial nerve (Case 3). Leptomeningeal enhancement is among the most common neurosarcoid radiologic findings (30–40%). Whereas benign increased intracranial tension (Case 4) is much less reported. Among sarcoidosis renal involvement (35–50%), interstitial nephritis usually presents with granulomatous renal lesions, yet its sole association with sarcoidosis is unusual (Case 4). The portrayed atypical hematologic, neurologic, and renal manifestations further emphasize the masquerading nature of sarcoidosis.http://www.sciencedirect.com/science/article/pii/S221300712100157XSarcoidosisMyelofibrosisEmperipolesisNeurosarcoidosisRenal involvementJuvenile |
| spellingShingle | Basma M. Medhat Mervat E. Behiry Mohamed Fateen Nehal El-Ghobashy Raghda Fouda Aya Embaby Esraa M. Seif Marwa Magdy Taha Mohammed Kamal Hasswa Dina Sobhy Christina Samir Ragheb Mohamed Abdelkader Morad Sarcoidosis beyond pulmonary involvement: A case series of unusual presentations Respiratory Medicine Case Reports Sarcoidosis Myelofibrosis Emperipolesis Neurosarcoidosis Renal involvement Juvenile |
| title | Sarcoidosis beyond pulmonary involvement: A case series of unusual presentations |
| title_full | Sarcoidosis beyond pulmonary involvement: A case series of unusual presentations |
| title_fullStr | Sarcoidosis beyond pulmonary involvement: A case series of unusual presentations |
| title_full_unstemmed | Sarcoidosis beyond pulmonary involvement: A case series of unusual presentations |
| title_short | Sarcoidosis beyond pulmonary involvement: A case series of unusual presentations |
| title_sort | sarcoidosis beyond pulmonary involvement a case series of unusual presentations |
| topic | Sarcoidosis Myelofibrosis Emperipolesis Neurosarcoidosis Renal involvement Juvenile |
| url | http://www.sciencedirect.com/science/article/pii/S221300712100157X |
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