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Fujimoto K, Norikane T, Yamamoto Y, Takami Y, Murota M, Shimada H, Dobahi H, Nishiyama Y. Cardiac Sarcoidosis Mimicking Lymphoma in a Patient With Sjogren’s Syndrome. Korean Circ J 2022; 52:715-716. [PMID: 35927038 PMCID: PMC9470492 DOI: 10.4070/kcj.2022.0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/18/2022] [Accepted: 06/01/2022] [Indexed: 11/11/2022] Open
Affiliation(s)
- Kengo Fujimoto
- Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Takashi Norikane
- Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yuka Yamamoto
- Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yasukage Takami
- Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Makiko Murota
- Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hiromi Shimada
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Hiroaki Dobahi
- Division of Hematology, Rheumatology and Respiratory Medicine, Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
| | - Yoshihiro Nishiyama
- Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan
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Xu J, Yang Y, Chen D, Lu Z, Ge J, Li X, Gao X. Co-Existence of Sarcoidosis and Sjögren's Syndrome with Hypercalcemia and Renal Involvement: A Case Report and Literature Review. Endocr Metab Immune Disord Drug Targets 2020; 21:768-776. [PMID: 32560621 DOI: 10.2174/1871530320666200619133654] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/30/2020] [Accepted: 05/04/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sarcoidosis and Sjögren's syndrome (SS) are chronic multi-system inflammatory diseases of unknown origin that most commonly attack the salivary glands. Both of the diseases have vague and non-specific symptoms, causing difficulties for the clinicians to distinguish between the two diseases. Main diagnostic criteria of SS exclude sarcoidosis. However, a co-existence of both diseases should be noted. Here, a case of co-existing sarcoidosis and Sjögren's syndrome is reported, complicated with severe hypercalcemia and renal failure, in addition to a literature review. CASE PRESENTATION A 71-year-old man visited our hospital complaining of daily progressive oral dryness, thirst, and blurred vision with a feeling of dry eyes for a one-year duration. His physical examination showed enlargement of both sides of cervical and supraclavicular lymph nodes. Lung auscultation showed decreased breath sounds with bibasilar inspiratory crackles. However, initial laboratory results revealed severe hypercalcemia with moderate hypercalciuria and renal failure. The final diagnosis was co-existing SS and sarcoidosis according to clinical, radiological, and laboratory data. The patient received oral prednisone therapy for 18 months. After a follow-up of years, the serum calcium concentration, renal function, and chest CT scan remained normal after prednisone treatment stopped for more than 18 months. CONCLUSION In the literature, calcium metabolic disorder and renal involvement have not been reported among patients with Sarcoidosis and Sjögren's syndrome, suggesting that calcium metabolic disorder may be underestimated. Serum and urine calcium concentration should be measured in addition to routine laboratory tests.
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Affiliation(s)
- Jing Xu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yumei Yang
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Dandan Chen
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Cardiovascular Disease Institute, Shanghai, China
| | - Zhiqiang Lu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Cardiovascular Disease Institute, Shanghai, China
| | - Xiaomu Li
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xin Gao
- Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
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Myachikova VY, Maslyansky AL, Shlyakhto EV, Lapin SV, Novikova AN, Trishina IN, Vorobieva OA, Fionik AM, Grozov RV, Gurkov AS. [Coexistence of pulmonary sarcoidosis and primary Sjögren's syndrome]. TERAPEVT ARKH 2016; 88:89-92. [PMID: 27030337 DOI: 10.17116/terarkh201688389-92] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The paper describes a case of a rare coexistence of primary Sjögren's syndrome (PSS) and sarcoidosis in a 41-year-old female with histologically verified lung and locomotor system diseases and keratoconjunctivitis sicca. PSS was diagnosed based on the 2012 ACR classification criteria, in the framework of which serological, histological, and gland function tests and instrumental diagnostic methods were performed. The diagnosis of sarcoidosis was based on clinical, radiographic, and histological findings.
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Affiliation(s)
- V Yu Myachikova
- I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
| | - A L Maslyansky
- V.A. Almazov North-West Federal Medical Research Center, Saint Petersburg, Russia
| | - E V Shlyakhto
- I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
| | - S V Lapin
- I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
| | - A N Novikova
- V.A. Almazov North-West Federal Medical Research Center, Saint Petersburg, Russia
| | - I N Trishina
- V.A. Almazov North-West Federal Medical Research Center, Saint Petersburg, Russia
| | - O A Vorobieva
- National Center for Clinical Morphological Diagnosis, Saint Petersburg, Russia
| | - A M Fionik
- I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
| | - R V Grozov
- V.A. Almazov North-West Federal Medical Research Center, Saint Petersburg, Russia
| | - A S Gurkov
- V.A. Almazov North-West Federal Medical Research Center, Saint Petersburg, Russia
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Dilektasli AG, Cetinoglu ED, Durmus E, Uzaslan E, Karadag M. Sarcoidosis and Sjögren's syndrome: Mimicry or coexistence? Kaohsiung J Med Sci 2015; 31:548-9. [PMID: 26520695 DOI: 10.1016/j.kjms.2015.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 07/03/2015] [Accepted: 07/15/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- Asli Gorek Dilektasli
- Department of Pulmonary Diseases, Uludag University Faculty of Medicine, Bursa, Turkey.
| | - Ezgi D Cetinoglu
- Department of Pulmonary Diseases, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Eda Durmus
- Department of Pulmonary Diseases, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Esra Uzaslan
- Department of Pulmonary Diseases, Uludag University Faculty of Medicine, Bursa, Turkey
| | - Mehmet Karadag
- Department of Pulmonary Diseases, Uludag University Faculty of Medicine, Bursa, Turkey
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Nessrine A, Zahra AF, Taoufik H. Musculoskeletal involvement in sarcoidosis. J Bras Pneumol 2014; 40:175-82. [PMID: 24831403 PMCID: PMC4083650 DOI: 10.1590/s1806-37132014000200012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Accepted: 02/21/2014] [Indexed: 01/30/2023] Open
Abstract
Sarcoidosis is a multisystem inflammatory disorder of unknown cause. It most commonly
affects the pulmonary system but can also affect the musculoskeletal system, albeit
less frequently. In patients with sarcoidosis, rheumatic involvement is polymorphic.
It can be the presenting symptom of the disease or can appear during its progression.
Articular involvement is dominated by nonspecific arthralgia, polyarthritis, and
Löfgren's syndrome, which is defined as the presence of lung adenopathy, arthralgia
(or arthritis), and erythema nodosum. Skeletal manifestations, especially dactylitis,
appear mainly as complications of chronic, multiorgan sarcoidosis. Muscle involvement
in sarcoidosis is rare and usually asymptomatic. The diagnosis of rheumatic
sarcoidosis is based on X-ray findings and magnetic resonance imaging findings,
although the definitive diagnosis is made by anatomopathological study of biopsy
samples. Musculoskeletal involvement in sarcoidosis is generally relieved with
nonsteroidal anti-inflammatory drugs or corticosteroids. In corticosteroid-resistant
or -dependent forms of the disease, immunosuppressive therapy, such as treatment with
methotrexate or anti-TNF-α, is employed. The aim of this review was to present an
overview of the various types of osteoarticular and muscle involvement in
sarcoidosis, focusing on their diagnosis and management.
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Mortazavi H, Baharvand M, Movahhedian A, Mohammadi M, Khodadoustan A. Xerostomia due to systemic disease: a review of 20 conditions and mechanisms. Ann Med Health Sci Res 2014; 4:503-10. [PMID: 25221694 PMCID: PMC4160670 DOI: 10.4103/2141-9248.139284] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Xerostomia is a common complaint of nearly half of the elderly population and about one-fifth of younger adults. It causes several signs and symptoms, and compromise oral functions and health-related quality-of-life. Multiple reasons are proposed to describe the etiology of xerostomia such as local factors, psychogenic factors, and systemic diseases. In order to manage xerostomia effectively, identification of the main causality is mandatory. The aim of this review was to present systemic diseases leading to xerostomia with their mechanisms of action. We used various general search engines and specialized databases such as Google, Google Scholar, Yahoo, PubMed, PubMed Central, MedLine Plus, Medknow, EBSCO, ScienceDirect, Scopus, WebMD, EMBASE, and authorized textbooks to find relevant topics by means of Medical Subject Headings keywords such as "xerostomia," "hyposalivations," "mouth dryness," "disease," and "systemic." We appraised 97 English-language articles published over the last 40 years in both medical and dental journals including reviews, meta-analysis, original papers, and case reports. Upon compilation of relevant data, it was concluded that autoimmune diseases most frequently involve salivary glands and cause xerostomia followed by diabetes mellitus, renal failure, and graft-versus-host disease. Moreover, the underlying mechanisms of systemic disease-related xerostomia are: autoimmunity, infiltration of immunocompetent cells, granuloma formation, fibrosis and dehydration, deposition of proteinaceous substances, bacterial infection, and side-effects of medications.
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Affiliation(s)
- H Mortazavi
- Department of Oral and Maxillofacial Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Baharvand
- Department of Oral and Maxillofacial Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - A Movahhedian
- Dental Student, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Mohammadi
- Dental Student, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Santiago T, Santiago M, Rovisco J, Ferreira J, Duarte C, Malcata A, Da Silva JAP. Coexisting primary Sjögren’s syndrome and sarcoidosis: coincidence, mutually exclusive conditions or syndrome? Rheumatol Int 2014; 34:1619-22. [DOI: 10.1007/s00296-014-3024-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 04/13/2014] [Indexed: 10/25/2022]
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Lim JHL, Chia FLA, Lim TCC, Ho BCS, Thirugnanam U, Thong BYH. A 62-Year-Old Man With Progressive Weakness, Multiple Neurologic Deficits, and Hypernatremia. Arthritis Care Res (Hoboken) 2013; 66:164-70. [DOI: 10.1002/acr.22150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2013] [Accepted: 08/27/2013] [Indexed: 11/11/2022]
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Mansour MJ, He C, Al-Farra ST, Khuder SA, Wright JM, Kessler HP, Hinton RJ, Al-Hashimi I. Sarcoidosis and Sjögren's syndrome: clinical and salivary evaluation. J Oral Pathol Med 2013; 42:594-9. [PMID: 23480241 DOI: 10.1111/jop.12057] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2013] [Indexed: 01/20/2023]
Abstract
BACKGROUND Sarcoidosis and Sjögren's syndrome are two different diseases; however, when affecting the salivary glands, both diseases exhibit similar clinical signs and symptoms, which often complicates the diagnosis. The purpose of this study was to investigate the possibility of using salivary electrophoresis to differentiate between the two diseases. METHODS Saliva was collected from patients with sarcoidosis and patients with Sjögren's syndrome. Salivary flow rate, total protein, and electrophoretic profiles were examined. RESULTS Mean salivary flow rate was 0.41 ± 0.07 ml/min/gland vs. 0.43 ± 0.07 ml/min/gland; total salivary protein was 130.0 ± 29.2 mg% vs. 104.0 ± 8.8 mg% for sarcoidosis vs. Sjögren's syndrome, respectively. No differences were observed in salivary flow rate, total salivary protein, or electrophoretic profile between patients with sarcoidosis and patients with Sjögren's syndrome (P = 0.768, 0.718, and 1.000, respectively). CONCLUSIONS Salivary protein electrophoresis does not appear to be useful to differentiate between sarcoidosis and Sjögren's syndrome.
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Likar-Manookin K, Stewart C, Al-Hashimi I, Curtis W, Berg K, Cherian K, Lockhart PB, Brennan MT. Prevalence of oral lesions of autoimmune etiology in patients with primary Sjogren's syndrome. Oral Dis 2012; 19:598-603. [PMID: 23279206 DOI: 10.1111/odi.12044] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2012] [Revised: 10/22/2012] [Accepted: 10/23/2012] [Indexed: 01/14/2023]
Abstract
OBJECTIVE The primary objective of this study was to determine the prevalence of oral lesions of autoimmune etiology (OLAIE) in a cohort of patients with primary Sjögren's syndrome (pSS). MATERIALS AND METHODS A multi-center retrospective cohort study was conducted at the oral medicine practices of Carolinas Medical Center (CMC), Baylor College of Dentistry (BCD), and the University of Florida (UF). Each site performed a chart review of patients with well-characterized pSS. Clinical variables such as OLAIE, traumatic lesions, and medical conditions were compiled at each site. The association between clinical variables and the presence of OLAIE was then assessed for significance. RESULTS We evaluated 155 patients diagnosed with pSS. Nineteen patients with pSS (12.3%) had an OLAIE. CMC reported 11 (21.2%) patients with OLAIE, while BCD and UF reported 4 (7.3%) and 4 (8.3%), respectively. Eleven of the 19 (58%) patients with OLAIE had lichen planus, 6 (32%) had aphthous stomatitis, 1 (5%) had chronic ulcerative stomatitis, and 1 (5%) had lesions of systemic connective tissue disease by immunofluorescence. CONCLUSION The results of our analysis suggest that patients with pSS have a 12% prevalence of OLAIE with a wide range (7.3-21.2%) found between practices. This difference is likely related to the different screening protocols for oral dryness between sites.
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Affiliation(s)
- K Likar-Manookin
- Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA.
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Sweiss NJ, Patterson K, Sawaqed R, Jabbar U, Korsten P, Hogarth K, Wollman R, Garcia JGN, Niewold TB, Baughman RP. Rheumatologic manifestations of sarcoidosis. Semin Respir Crit Care Med 2010; 31:463-73. [PMID: 20665396 DOI: 10.1055/s-0030-1262214] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Sarcoidosis is a systemic, clinically heterogeneous disease characterized by the development of granulomas. Any organ system can be involved, and patients may present with any number of rheumatologic symptoms. There are no U.S. Food and Drug Administration-approved therapies for the treatment of sarcoidosis. Diagnosing sarcoidosis becomes challenging, particularly when its complications cause patients' symptoms to mimic other conditions, including polymyositis, Sjögren syndrome, or vasculitis. This review presents an overview of the etiology of and biomarkers associated with sarcoidosis. We then provide a detailed description of the rheumatologic manifestations of sarcoidosis and present a treatment algorithm based on current clinical evidence for patients with sarcoid arthritis. The discussion will focus on characteristic findings in patients with sarcoid arthritis, osseous involvement in sarcoidosis, and sarcoid myopathy. Arthritic conditions that sometimes coexist with sarcoidosis are described as well. We present two cases of sarcoidosis with rheumatologic manifestations. Our intent is to encourage a multidisciplinary, translational approach to meet the challenges and difficulties in understanding and treating sarcoidosis.
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Affiliation(s)
- Nadera J Sweiss
- Section of Rheumatology, Department of Medicine, University of Chicago Medical Center, Chicago, IL 60637, USA.
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Current World Literature. Curr Opin Rheumatol 2009; 21:85-92. [DOI: 10.1097/bor.0b013e32832355a7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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