Abstract
Objective
To analyze the pattern of osteoarticular lesions in patients with sarcoidosis hospitalized in 4 rheumatology departments.
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%), poly-arthritis (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 poly-arthritis 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.
Key Indexing Terms:Footnotes
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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.
- Accepted for publication March 10, 2008.
