Osseous sarcoidosis: a multicenter case-control study

Abstract : Objective: To describe the clinical presentation, distribution of lesions, treatment, and outcomes of osseous sarcoidosis. Methods: A French retrospective multicenter study of patients with biopsy-proven sarcoidosis analyzed patients with 1) a biopsy-proven granuloma without caseous necrosis, and either 2) osseous clinical manifestations, or 3) abnormal osseous imaging. Sarcoidosis patients with osseous involvement (cases) were compared with 264 age- and sex-matched sarcoidosis patients with no osseous manifestations (controls). Results: In the osseous sarcoidosis group (n = 88), forty-two (48%) patients had osseous-related symptoms involving the axial (69%) and/or appendicular (58%) skeleton. On imaging, the most commonly affected bones were in the spine (52%), pelvis (42%), hands (22%) and femur (19%). Compared with controls, cases had higher rates of mediastinal (93% vs. 47%) and extra-thoracic lymph node involvement (66% vs. 21%), pulmonary (90% vs. 65%) and cutaneous involvement (44% vs. 23%) (all P < 0.0001), and hypercalcemia (8.5% vs. 2%, P = 0.014). Spleen/liver and gastrointestinal involvement were less frequent in the osseous sarcoidosis group (29% vs. 45%, and 1% vs. 17%, respectively, P < 0.0001). Response rates to with glucocorticoids alone, glucocorticoids plus methotrexate or glucocorticoids plus hydroxychloroquine were 23/44 (52%), 9/13 (69%) and 4/6 (67%), respectively. Conclusion: In patients with osseous sarcoidosis the spine and pelvis were the most commonly affected bones. Compared with controls, cases with osseous sarcoidosis have higher rates of thoracic and extra-thoracic lymph node involvement, pulmonary and cutaneous involvement, and hypercalcemia. Most patients with osseous sarcoidosis had a good response to glucocorticoids in combination with methotrexate or hydroxychloroquine.
Complete list of metadatas

Cited literature [25 references]  Display  Hide  Download

https://hal.sorbonne-universite.fr/hal-02291291
Contributor : Gestionnaire Hal-Su <>
Submitted on : Wednesday, September 18, 2019 - 3:38:50 PM
Last modification on : Friday, September 20, 2019 - 1:12:35 AM

File

 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : 2020-01-30

Please log in to resquest access to the document

Identifiers

Citation

Imen Ben Hassine, Christopher Rein, Cloé Comarmond, Camille Glanowski, Nathalie Saidenberg-Kermanac’h, et al.. Osseous sarcoidosis: a multicenter case-control study. Joint Bone Spine, Elsevier Masson, In press, ⟨10.1016/j.jbspin.2019.07.009⟩. ⟨hal-02291291⟩

Share

Metrics

Record views

86