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Osteoarticular Involvement in a Series of 100 Patients with Sarcoidosis Referred to Rheumatology Departments
NATACHA THELIER, NOÉMIE ASSOUS, CHANTAL JOB-DESLANDRE, OLIVIER MEYER, THOMAS BARDIN, PHILIPPE ORCEL, FRÉDÉRIC LIOTÉ, MAXIME DOUGADOS, ANDRE KAHAN, and YANNICK ALLANORE
ABSTRACT. Methods. We carried out a systematic retrospective analysis of cases with sarcoidosis admitted in the last 10 years, using hospital databases. Two distinct groups were defined from the outset: patients with Löfgren's syndrome (LS) or sarcoid rheumatism (SR). We assessed the following items: distribution of arthritis, chronicity, systemic manifestations, biochemical and immunological measures. Results. We included 100 patients (75% women); 43% had LS and 57% SR. Osteoarticular symptoms revealed the disease in 85% of patients. The patients in the LS group were younger than those in the SR group (41 ± 9 vs 48 ± 13 yrs; p < 0.006) and were more likely to have oligoarthritis involving ankles (58% vs 32%; p = 0.04) and high C-reactive protein concentrations (63% vs 33%; p < 0.005). Patients with SR presented osteoarticular symptoms in the form of oligoarthritis (32%), polyarthritis (32%), bony erosion in 8/57 (14%), and osteitis in 9/57 (16%). Lung interstitial involvement was more frequent in the SR group than in the LS group (38% vs 18%; p = 0.03). Chronic polyarthritis was associated with the detection of rheumatoid factor (p = 0.004). Osteitis occurred in older patients (p = 0.02). Conclusion. SR was the most frequent manifestation leading to hospitalization; it was characterized by oligoarthritis and polyarthritis and associated with interstitial lung involvement. Osseous involvement occurred in a quarter of SR patients with similar frequency of erosions targeting the distal small bones and osteitis. These latter occurred at a later age. (First Release July 15 2008; J Rheumatol 2008;35:1622–8) Key Indexing Terms:
SARCOIDOSIS
From the Department of Rheumatology A, Paris Descartes University, Medical School, Cochin Hospital, l'Assistance Publique-Hôpitaux de Paris (AP-HP); Department of Rheumatology, Denis Diderot Paris 7 University, Medical Faculty, Bichat Hospital, AP-HP; Department of Rheumatology, Denis Diderot Paris 7, Medical Faculty, Lariboisière Hospital, AP-HP; and Department of Rheumatology B, René Descartes University, Medical Faculty, Cochin Hospital, AP-HP, Paris, France. N. Thelier, MD; N. Assous, MD; C. Job-Deslandre, MD, Department of Rheumatology A, Paris Descartes University, Medical School, Cochin Hospital; O. Meyer, MD, PhD, Department of Rheumatology, Denis Diderot Paris 7 University, Medical Faculty, Bichat Hospital; T. Bardin, MD; P. Orcel, MD, PhD; F. Lioté, MD, PhD, Department of Rheumatology, Denis Diderot Paris 7, Medical Faculty, Lariboisière Hospital; M. Dougados, MD, Department of Rheumatology B, René Descartes University, Medical Faculty, Cochin Hospital; A. Kahan, MD, PhD; Y. Allanore, MD, PhD, Department of Rheumatology A, Paris Descartes University, Medical School, Cochin Hospital. Address reprint requests to Dr. Y. Allanore, Hôpital Cochin, Service de rhumatologie A, 27 rue du Faubourg Saint Jacques, 75014 Paris, France. E-mail: yannick.allanore@cch.aphp.fr Accepted for publication March 10, 2008. |
