Rheumatologic Manifestations of Sarcoidosis

Nadera J Sweiss; Karen Patterson; Ray Sawaqed; Umair Jabbar; Peter Korsten; Kyle Hogarth; Robert Wollman; Joe G.N Garcia; Timothy B Niewold; Robert P Baughman

doi:10.1055/s-0030-1262214

Seminars in Respiratory and Critical Care Medicine, Inhaltsverzeichnis

Semin Respir Crit Care Med 2010; 31(4): 463-473
DOI: 10.1055/s-0030-1262214

Rheumatologic Manifestations of Sarcoidosis

Nadera J. Sweiss¹ , Karen Patterson² , Ray Sawaqed³ , Umair Jabbar⁴ , Peter Korsten⁵ , Kyle Hogarth² , Robert Wollman⁶ , Joe G.N Garcia⁷ , Timothy B. Niewold² , Robert P. Baughman⁸

¹Section of Rheumatology, Department of Medicine, University of Chicago Medical Center, Chicago, Illinois
²Pulmonary and Critical Care Medicine, University of Chicago Medical Center, Chicago, Illinois
³Department of Cardiothoracic Surgery, Methodist Hospital, Merrillville, Indiana
⁴Stritch School of Medicine, Loyola University Chicago, Chicago, Illinois
⁵Department of Nephrology and Rheumatology, University of Goettingen, Goettingen, Germany
⁶Department of Pathology, University of Chicago Medical Center, Chicago, Illinois
⁷Department of Medicine/Pulmonary and Critical Care Medicine, University of Illinois at Chicago, Chicago, Illinois
⁸Division of Pulmonary and Critical Care, University of Cincinnati Medical Center, Cincinnati, Ohio

Abstract

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.

KEYWORDS

Sarcoidosis - rheumatic diseases - arthritis - myopathy

Volltext

Referenzen

REFERENCES

1 Hofmann S, Franke A, Fischer A et al.. Genome-wide association study identifies ANXA11 as a new susceptibility locus for sarcoidosis. Nat Genet. 2008; 40 1103-1106
2 Chen E S, Moller D R. Etiology of sarcoidosis. Clin Chest Med. 2008; 29 365-377, vii
3 Smith G, Brownell I, Sanchez M, Prystowsky S. Advances in the genetics of sarcoidosis. Clin Genet. 2008; 73 401-412
4 Drake W P, Newman L S. Mycobacterial antigens may be important in sarcoidosis pathogenesis. Curr Opin Pulm Med. 2006; 12 359-363
5 Ezzie M E, Crouser E D. Considering an infectious etiology of sarcoidosis. Clin Dermatol. 2007; 25 259-266
6 Maples C J, Counselman F L. Lupus pernio. J Emerg Med. 2007; 33 187-189
7 Wilcox A, Bharadwaj P, Sharma O P. Bone sarcoidosis. Curr Opin Rheumatol. 2000; 12 321-330
8 Bargagli E, Olivieri C, Penza F et al.. Rare localizations of bone sarcoidosis: two case reports and review of the literature. Rheumatol Int. 2009 Dec. 15;
9 Chatham W. Rheumatic manifestations of systemic disease: sarcoidosis. Curr Opin Rheumatol. 2010; 22 85-90
10 Ugwonali O F, Parisien M, Nickerson K G, Scully B, Ristic S, Strauch R J. Osseous sarcoidosis of the hand: pathologic analysis and review of the literature. J Hand Surg [Am]. 2005; 30 854-858
11 Shorr A F, Murphy F T, Kelly W F, Kaplan K J, Gilliland W R, Shapeero L G. Osseous sarcoidosis clinical, radiographic, and therapeutic observations. J Clin Rheumatol. 1998; 4 186-192
12 Shorr A F, Murphy F T, Gilliland W R, Hnatiuk W. Osseous disease in patients with pulmonary sarcoidosis and musculoskeletal symptoms. Respir Med. 2000; 94 228-232
13 Rúa-Figueroa I, Gantes M A, Erausquin C, Mhaidli H, Montesdeoca A. Vertebral sarcoidosis: clinical and imaging findings. Semin Arthritis Rheum. 2002; 31 346-352
14 Binicier O, Sari I, Sen G et al.. Axial sarcoidosis mimicking radiographic sacroiliitis. Rheumatol Int. 2009; 29 343-345
15 Moore S L, Teirstein A E. Musculoskeletal sarcoidosis: spectrum of appearances at MR imaging. Radiographics. 2003; 23 1389-1399
16 Mangino D, Stover D E. Sarcoidosis presenting as metastatic bony disease: a case report and review of the literature on vertebral body sarcoidosis. Respiration. 2004; 71 292-294
17 Garg S, Garg K, Altaf M, Magaldi J A. Refractory vertebral sarcoidosis responding to infliximab. J Clin Rheumatol. 2008; 14 238-240
18 Kötter I, Dürk H, Saal J G. Sacroiliitis in sarcoidosis: case reports and review of the literature. Clin Rheumatol. 1995; 14 695-700
19 Erb N, Cushley M J, Kassimos D G, Shave R M, Kitas G D. An assessment of back pain and the prevalence of sacroiliitis in sarcoidosis. Chest. 2005; 127 192-196
20 Griep E N, van Spiegel P I, van Soesbergen R M. Sarcoidosis accompanied by pulmonary tuberculosis and complicated by sacroiliitis. Arthritis Rheum. 1993; 36 716-721
21 Zisman D A, Biermann J S, Martinez F J, Devaney K O, Lynch III J P. Sarcoidosis presenting as a tumorlike muscular lesion: case report and review of the literature. Medicine (Baltimore). 1999; 78 112-122
22 Moore S L, Teirstein A E, Tohme-Noun C et al.. Musculoskeletal sarcoidosis: spectrum of appearances at MR imaging. Radiographics. 2003; 23 1389-1399
23 Torralba K D, Quismorio Jr F P. Sarcoidosis and the rheumatologist. Curr Opin Rheumatol. 2009; 21 62-70
24 Nemoto I, Shimizu T, Fujita Y, Tateishi Y, Tsuji-Abe Y, Shimizu H. Tumour-like muscular sarcoidosis. Clin Exp Dermatol. 2007; 32 298-300
25 Le Roux K, Streichenberger N, Vial C et al.. Granulomatous myositis: a clinical study of thirteen cases. Muscle Nerve. 2007; 35 171-177
26 Matsui K, Adachi M, Kawasaki Y, Matsuda K, Shinohara K. Sarcoidosis acutely involving the musculoskeletal system. Intern Med. 2007; 46 1471-1474
27 Fayad F, Lioté F, Berenbaum F, Orcel P, Bardin T. Muscle involvement in sarcoidosis: a retrospective and followup studies. J Rheumatol. 2006; 33 98-103
28 Sève P, Zénone T, Durieu I, Pillon D, Durand D V. Muscular sarcoidosis: apropos of a case [in French]. Rev Med Interne. 1997; 18 984-988
29 Danon M J, Perurena O H, Ronan S, Manaligod J R. Inclusion body myositis associated with systemic sarcoidosis. Can J Neurol Sci. 1986; 13 334-336
30 Vattemi G, Tonin P, Marini M et al.. Sarcoidosis and inclusion body myositis. Rheumatology (Oxford). 2008; 47 1433-1435
30a Larue S, Maisonobe T, Benveniste O et al.. Distal muscle involvement in granulomatous myositis can mimic inclusion body myositis. J Neurol Neurosurg Psychatry. 2010; , June 20 [Epub ahead of print]
31 Fernandes S R, Singsen B H, Hoffman G S. Sarcoidosis and systemic vasculitis. Semin Arthritis Rheum. 2000; 30 33-46
32 Stone J. Rituximab versus cyclophosphamide for induction of remission in ANCA-associated vasculitis: a randomized controlled trial (RAVE). American College of Rheumatology Conference; October 16–21, 2009 Philadelphia, PA; Arthritis & Rheumatism 2009 60(Suppl 10): abstract 550
33 Mansour M J, Al-Hashimi I, Wright J M. Coexistence of Sjögren’s syndrome and sarcoidosis: a report of five cases. J Oral Pathol Med. 2007; 36 337-341
34 Rudralingam M, Nolan A, Macleod I, Greenwood M, Heath N. A case of sarcoidosis presenting with diffuse, bilateral swelling of the salivary glands. Dent Update. 2007; 34 439-440 442
35 Hansen S R, Hetta A K, Omdal R. Primary Sjögren’s syndrome and sarcoidosis: coexistence more than by chance?. Scand J Rheumatol. 2008; 37 485-486
36 van de Loosdrecht A, Kalk W, Bootsma H, Henselmans J M, Kraan J, Kallenberg C G. Simultaneous presentation of sarcoidosis and Sjögren’s syndrome. Rheumatology (Oxford). 2001; 40 113-115
37 Bamba R, Sweiss N J, Langerman A J, Taxy J B, Blair E A. The minor salivary gland biopsy as a diagnostic tool for Sjogren syndrome. Laryngoscope. 2009; 119 1922-1926
38 Stonecipher K, Perry H D, Gross R H, Kerney D L. The impact of topical cyclosporine A emulsion 0.05% on the outcomes of patients with keratoconjunctivitis sicca. Curr Med Res Opin. 2005; 21 1057-1063
39 Perruquet J L, Harrington T M, Davis D E, Viozzi F J. Sarcoid arthritis in a North American Caucasian population. J Rheumatol. 1984; 11 521-525
40 Pettersson T. Sarcoid and erythema nodosum arthropathies. Best Pract Res Clin Rheumatol. 2000; 14 461-476
41 Spilberg I, Siltzbach L E, McEwen C. The arthritis of sarcoidosis. Arthritis Rheum. 1969; 12 126-137
42 Visser H, Vos K, Zanelli E et al.. Sarcoid arthritis: clinical characteristics, diagnostic aspects, and risk factors. Ann Rheum Dis. 2002; 61 499-504
43 Ohta H, Tazawa R, Nakamura A et al.. Acute-onset sarcoidosis with erythema nodosum and polyarthralgia (Löfgren’s syndrome) in Japan: a case report and a review of the literature. Intern Med. 2006; 45 659-662
44 Sato T, Tsuru T, Hagiwara K et al.. Sarcoidosis with acute recurrent polyarthritis and hypercalcemia. Intern Med. 2006; 45 363-368
45 Chu A, Ginat D, Terzakis J, Seneviratne A, Schneider K S. Chronic sarcoid arthritis presenting as an intra-articular knee mass. J Clin Rheumatol. 2009; 15 190-192
46 Glennås A, Kvien T K, Melby K et al.. Acute sarcoid arthritis: occurrence, seasonal onset, clinical features and outcome. Br J Rheumatol. 1995; 34 45-50
47 Gran J T, Bøhmer E. Acute sarcoid arthritis: a favourable outcome? A retrospective survey of 49 patients with review of the literature. Scand J Rheumatol. 1996; 25 70-73
48 Grunewald J, Eklund A. Role of CD4 + T cells in sarcoidosis. Proc Am Thorac Soc. 2007; 4 461-464
49 Thelier N, Assous N, Job-Deslandre C et al.. Osteoarticular involvement in a series of 100 patients with sarcoidosis referred to rheumatology departments. J Rheumatol. 2008; 35 1622-1628
50 Neville E, Walker A N, James D G. Prognostic factors predicting the outcome of sarcoidosis: an analysis of 818 patients. Q J Med. 1983; 52 525-533
51 Pennec Y, Youinou P, Le Goff P, Boles J M, Le Menn G. Comparison of the manifestations of acute sarcoid arthritis with and without erythema nodosum. Immunopathogenic significance. Scand J Rheumatol. 1982; 11 13-16
52 Anandacoomarasamy A, Peduto A, Howe G, Manolios N, Spencer D. Magnetic resonance imaging in Löfgren’s syndrome: demonstration of periarthritis. Clin Rheumatol. 2007; 26 572-575
53 Kellner H, Späthling S, Herzer P. Ultrasound findings in Löfgren’s syndrome: is ankle swelling caused by arthritis, tenosynovitis or periarthritis?. J Rheumatol. 1992; 19 38-41
54 Proulx A M, Zryd T W. Costochondritis: diagnosis and treatment. Am Fam Physician. 2009; 80 617-620
55 Baughman R P, Iannuzzi M C. Diagnosis of sarcoidosis: when is a peek good enough?. Chest. 2000; 117 931-932
56 Kaplan H, Klatskin G. Sarcoidosis, psoriasis, and gout: syndrome or coincidence?. Yale J Biol Med. 1960; 32 335-352
57 Goldstein R A, Becker K L, Israel H L, Moore C F. Urate metabolism in sarcoidosis. Arch Intern Med. 1974; 133 379-381
58 Longcope W T, Freiman D G. A study of sarcoidosis; based on a combined investigation of 160 cases including 30 autopsies from The Johns Hopkins Hospital and Massachusetts General Hospital. Medicine (Baltimore). 1952; 31 1-132
59 Healy P J, Helliwell P S. Dactylitis: pathogenesis and clinical considerations. Curr Rheumatol Rep. 2006; 8 338-341
60 Rothschild B M, Pingitore C, Eaton M. Dactylitis: implications for clinical practice. Semin Arthritis Rheum. 1998; 28 41-47
61 Kircik L H, Del Rosso J Q. Anti-TNF agents for the treatment of psoriasis. J Drugs Dermatol. 2009; 8 546-559
62 Cuchacovich R, Espinoza C G, Virk Z, Espinoza L R. Biologic therapy (TNF-alpha antagonists)-induced psoriasis: a cytokine imbalance between TNF-alpha and IFN-alpha?. J Clin Rheumatol. 2008; 14 353-356
63 Baughman R P, Lower E E. A clinical approach to the use of methotrexate for sarcoidosis. Thorax. 1999; 54 742-746
64 Braun J, Rau R. An update on methotrexate. Curr Opin Rheumatol. 2009; 21 216-223
65 Saag K G, Teng G G, Patkar N M American College of Rheumatology et al. American College of Rheumatology 2008 recommendations for the use of nonbiologic and biologic disease-modifying antirheumatic drugs in rheumatoid arthritis. Arthritis Rheum. 2008; 59 762-784
66 Moravan M, Segal B M. Treatment of CNS sarcoidosis with infliximab and mycophenolate mofetil. Neurology. 2009; 72 337-340
67 Agrawal S, Bhagat S, Dasgupta B. Sarcoid sacroiliitis: successful treatment with infliximab. Ann Rheum Dis. 2009; 68 283
68 Santos E, Shaunak S, Renowden S A, Scolding N J. Treatment of refractory neurosarcoidosis with infliximab. J Neurol Neurosurg Psychiatry. 2010; 81 241-246
69 Barnabe C, McMeekin J, Howarth A, Martin L. Successful treatment of cardiac sarcoidosis with infliximab. J Rheumatol. 2008; 35 1686-1687
70 Sweiss N J, Baughman R P. Tumor necrosis factor inhibition in the treatment of refractory sarcoidosis: slaying the dragon?. J Rheumatol. 2007; 34 2129-2131
71 Sweiss N J, Curran J, Baughman R P. Sarcoidosis, role of tumor necrosis factor inhibitors and other biologic agents, past, present, and future concepts. Clin Dermatol. 2007; 25 341-346
72 Sweiss N J, Hushaw L L. Biologic agents for rheumatoid arthritis: 2008 and beyond. J Infus Nurs. 2009; 32(1 Suppl) S4-17 quiz S19-24
73 Sweiss N J, Welsch M J, Curran J J, Ellman M H. Tumor necrosis factor inhibition as a novel treatment for refractory sarcoidosis. Arthritis Rheum. 2005; 53 788-791
74 Palucka A K, Blanck J P, Bennett L, Pascual V, Banchereau J. Cross-regulation of TNF and IFN-alpha in autoimmune diseases. Proc Natl Acad Sci U S A. 2005; 102 3372-3377
75 Kariuki S N, Crow M K, Niewold T B. The PTPN22 C1858T polymorphism is associated with skewing of cytokine profiles toward high interferon-alpha activity and low tumor necrosis factor alpha levels in patients with lupus. Arthritis Rheum. 2008; 58 2818-2823
76 Mavragani C P, Niewold T B, Moutsopoulos N M, Pillemer S R, Wahl S M, Crow M K. Augmented interferon-alpha pathway activation in patients with Sjögren’s syndrome treated with etanercept. Arthritis Rheum. 2007; 56 3995-4004
77 Doyle M K, Berggren R, Magnus J H. Interferon-induced sarcoidosis. J Clin Rheumatol. 2006; 12 241-248
78 Niewold T B. Interferon alpha-induced lupus: proof of principle. J Clin Rheumatol. 2008; 14 131-132
79 Belkhou A, Younsi R, El Bouchti I, El Hassani S. Rituximab as a treatment alternative in sarcoidosis. Joint Bone Spine. 2008; 75 511-512
80 Kausar F, Mustafa K, Sweis G et al.. Ocrelizumab: a step forward in the evolution of B-cell therapy. Expert Opin Biol Ther. 2009; 9 889-895

Nadera J SweissM.D.

Section of Rheumatology, Department of Medicine, University of Chicago Medical Center

5841 S. Maryland Ave., MC0930 Rm. N005B, Chicago, IL 60637

eMail: nsweiss@medicine.bsd.uchicago.edu