ABSTRACT
Introducción: La sarcoidosis es un desorden multisistémico de causa desconocida. El curso de la enfermedad es variable, puede ser asintomático con resolución espontánea o progresar con fallo orgánico llegando incluso a la muerte. Objetivo: Describir el protocolo diagnóstico ante la sospecha de sarcoidosis. Presentación del caso: Se presenta un caso clínico con varios síntomas y signos aparentemente no relacionados entre sí, en el que se implementa un algoritmo descrito en la literatura foránea. Conclusiones: La interdisciplinariedad fue necesaria para el correcto manejo de este caso, en la cual los internistas como moderadores fueron fundamentales pues permitió una visión integral del enfermo(AU)
Introduction: Sarcoidosis is a multisystemic disorder of unknown cause. The course of the disease is variable, it can be asymptomatic with spontaneous resolution or progress with organ failure, even death. Objective: To describe the diagnostic protocol for suspected sarcoidosis. Case report: A clinical case is report here with several apparently unrelated symptoms and signs, in which an algorithm described in foreign literature is implemented. Conclusions: Interdisciplinarity was necessary for the correct management of this case, in which internists as moderators were fundamental because it allowed a comprehensive vision of the patient(AU)
Subject(s)
Humans , Sarcoidosis/diagnosis , Sarcoidosis/etiology , Biopsy/methodsSubject(s)
Humans , Male , Adult , Sarcoidosis/etiology , Atrioventricular Block/diagnostic imaging , Heart Diseases/complications , Heart Diseases/diagnostic imaging , Azathioprine/pharmacology , Time Factors , Echocardiography , Magnetic Resonance Spectroscopy , Methotrexate/toxicity , Tachycardia, Ventricular/complications , Bisoprolol/chemistry , Adrenal Cortex Hormones/administration & dosage , Computed Tomography Angiography , Heart Failure/complications , Amiodarone/chemistry , Anticoagulants/chemistryABSTRACT
Abstract Numerous infectious, inflammatory and neoplastic complications secondary to tattoo placement have been reported in the literature. Within inflammatory complications sarcoidal granulomatous reactions have been described. We report two cases, a 55-year-old woman with yellowish infiltrated plaques on bilateral ciliary region, 16 years after the placement of a permanent tattoo in the eyebrows, and a 20-year-old tattoo artist who developed orange papules on 3 of his tattoos. Histopathology in both cases confirmed diagnosis of sarcoidal granulomatous reaction due to tattoo pigment.
Subject(s)
Humans , Female , Middle Aged , Tattooing/adverse effects , Dermatitis/etiology , Dermatitis/pathology , Granuloma/etiology , Granuloma/pathology , Sarcoidosis/etiology , Sarcoidosis/pathology , Dermis/pathology , EyebrowsABSTRACT
Abstract Sarcoidosis is a disease which still has uncertain etiology. Possible environmental causes are cited in the literature, like organic and inorganic particles and infectious agents. Recent studies have demonstrated the occurrence of sarcoidosis in patients with chronic C hepatitis; however, this association remains without statistical or causal evidence. In this report a case of sarcoidosis associated with chronic hepatitis C will be described, with subcutaneous lesions, considered rare, and good response to treatment with colchicine and prednisone. The hepatitis C virus was isolated in sarcoid tissue and the association between the two diseases will be discussed.
Subject(s)
Humans , Female , Middle Aged , Sarcoidosis/drug therapy , Prednisone/therapeutic use , Colchicine/therapeutic use , Hepatitis C, Chronic/drug therapy , Glucocorticoids/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Sarcoidosis/etiology , Sarcoidosis/pathology , Polymerase Chain Reaction , Treatment Outcome , Hepatitis C, Chronic/complicationsSubject(s)
Humans , Male , Female , Cardiovascular Diseases/complications , Cardiovascular Diseases/etiology , Inflammation , Positron-Emission Tomography , Atherosclerosis/etiology , Atherosclerosis , Endocarditis, Bacterial/etiology , Endocarditis, Bacterial , Sarcoidosis/etiology , Sarcoidosis , Vasculitis/etiology , VasculitisABSTRACT
El síndrome de Lõfgren, es una variante aguda de la sarcoidosis, que se caracteriza por fiebre, eritema nodoso, adenomegalias hiliares pulmonares y artritis. En general, tiene un curso benigno y autolimitado, que contrasta con las formas crónicas que requieren uso de corticoides y tienen tendencia a la recidiva. Se describe aquí el caso clínico de un paciente joven, de sexo masculino, con artritis pero sin eritema nodoso, lo que dificultó el planteo diagnóstico de síndrome de Lõfgren. Se realiza además una breve descripción comparativa entre la presentación clínica de la sarcoidosis crónica y el síndrome de Lõfgren...
Subject(s)
Humans , Male , Arthritis/diagnosis , Arthritis/therapy , Erythema Nodosum/diagnosis , Erythema Nodosum/therapy , Sarcoidosis/diagnosis , Sarcoidosis/etiology , Sarcoidosis/therapyABSTRACT
Tattooing has been practiced in India since ancient era. It has tremendous religious and spiritual significance. In addition, tattooing for cosmetic purposes has become quite popular in recent times. With this increasing trend, there is also an increased risk of adverse effects. Here, we have described two cases of lichenoid reaction developing to red ink in double- colored tattoos and a case of sarcoidal reaction to green tattoo.
Subject(s)
Adult , Epidemics , Female , Humans , Lichenoid Eruptions/diagnosis , Lichenoid Eruptions/epidemiology , Lichenoid Eruptions/etiology , Male , Sarcoidosis/diagnosis , Sarcoidosis/epidemiology , Sarcoidosis/etiology , Tattooing/adverse effects , Tattooing/trends , Young AdultABSTRACT
La sarcoidosis es una enfermedad inflamatoria granulomatosa crónica multisistémica, de etiología desconocida, que afecta principalmente el aparato respiratorio, sobre todo el inferior, y a adultos jóvenes, y es rara en la vía respiratoria superior (fosas y senos paranasales, y laringe). Se manifiesta de forma muy inespecífica, con clínica secundaria a obstrucción de la vía aérea. El diagnóstico se establece cuando los hallazgos clínico-radiológicos se apoyan en granulomas tuberculoides no caseificantes. El tratamiento de base son medidas de soporte, debido a la remisión espontánea
The sarcoidosis is an inflammatory granulomatos multisystemic chronic disease of unknown etiology, that mainly affects the respiratory tract, mainly the lower one and in young adults; being rare the affectation of the upper respiratory tract (nose, paranasal sinus and larynx). It manifests with many unspecific form, and with symptoms secondary to the airways obstruction. The diagnosis is established when the clinical and radiological findings are supported in tuberculoid granulomas without caseum. The base of the treatment are support measurements due to the spontaneous remission
Subject(s)
Humans , Respiratory Tract Diseases , Respiratory Tract Infections , Sarcoidosis , Sarcoidosis/etiology , Sarcoidosis/therapy , Respiratory SystemABSTRACT
La sarcoidosis es una enfermedad multisistémica perteneciente a la familia de las afecciones granulomatosas, caracterizada por la presencia de granulomas no caseificantes en los órganos afectados.Tiene una distribución universal y hasta el momento no ha sido aislado ningún agente responsable. Se diagnostica por la combinación del cuadro clínico y radiológico con la presencia de granulomas no caseificantes en los tejidos en los que los cultivos para micobacterias y hongos, capaces de producir un cuadro clínico e histopatológico similar, hayan sido negativos. Dada la heterogenicidad de las manifestaciones clínicas, el curso clínico incierto y los potenciales efectos adversos de la medicación, se hace difícil el manejo. Los pacientes se observan sin tratamiento, por la posibilidad de curación espontánea. Los esteroides son la base del tratamiento de la sarcoidosis y con la tecnología disponible quizás en la próxima década aumente nuestro conocimiento de la enfermedad y contemos con terapia específica
Sarcoidosis is a multisystem disease including the granulomatous affections, characterized by presence of non-caseinogen granulomas in involved organs. It has a universal distribution and until now hasn't been isolated any responsible agent. Diagnosis was based on in a combination of clinical and radiological picture with the presence of non-caseinogen granulomas in tissues where the cultures for mycobacteria and fungi, able to produce a similar clinical and pathologic histology picture were negatives. Due to heterogeneity of clinical manifestations, the uncertain clinical course and the medication potential adverse effects of, to difficult its management. Patients are seen without treatment due to possibility of a spontaneous cure. Steroids are the basis of Sarcoidosis treatment and with the available technology maybe in next decade increase our knowledge of this disease as well as a specific therapy
Subject(s)
Humans , Sarcoidosis/etiology , Sarcoidosis/pathology , Bronchoscopy/methodsABSTRACT
La sarcoidosis es una enfermedad granulomatosa multisistémica de etiología desconocida. Entre sus manifestaciones clínicas destaca la afectación cutánea, existiendo lesiones específicas e inespecíficas, pudiendo ser la primera manifestación de la enfermedad. Presentamos tres pacientes con sarcoidosis; dos de los casos expresaron la enfermedad como granuloma anular generalizado y el otro caso se manifestó con nódulos subcutáneos.
Sarcoidosis is a multisystemic granulomatous disease of unknown etiology. Cutaneous lesions, both specific and non specific, stand out among other clinical manifestations and can be the first manifestation of the disease. We present three patients with sarcoidosis, two cases present as generalized granuloma annulare, and the third as subcutaneous nodules.
Subject(s)
Humans , Male , Female , Middle Aged , Skin Diseases/pathology , Sarcoidosis/pathology , Adrenal Cortex Hormones/therapeutic use , Skin Diseases/diagnosis , Skin Diseases/etiology , Skin Diseases/drug therapy , Sarcoidosis/diagnosis , Sarcoidosis/etiology , Sarcoidosis/drug therapyABSTRACT
A sarcoidose é uma doença sistêmica de etiologia desconhecida, com apresentação clínica variável, onde 30 a 50% dos pacientes são assintomáticos ao diagnóstico. Afeta a pele, pulmões, sistema linfático, fígado e olhos. Outras áreas menos frequentemente afetadas são falanges ósseas, miocárdio, sistema nervoso central, fígado, baço e parótidas. A pele está envolvida em 25 a 35% dos casos, com diferentes formas de apresentação das lesões cutâneas. Relata-se caso de paciente de 26 anos cuja manifestação inicial da sarcoidose foram nódulos cutâneos em cicatrizes prévias e em que na investigação adicional mostrou-se haver acometimento pulmonar e mediastinal.
Sarcoidosis is a systemic disorder of unknown etiology and variable clinical presentation, where 30-50% of patients are asymptomatic at diagnosis. It affects the skin, lungs, lymphatic system, liver, and eyes. Less frequently affected areas are bone phalanxes, myocardium, central nervous system, liver, spleen and parotids. The skin is involved in 25-35% of the cases with different forms of presentation of skin lesions. Here the authors report the case of a 26-year-oldwhose initial manifestation of sarcoidosis were skin nodules on previous scars and which further investigation showed affected lung and mediastinum.
Subject(s)
Humans , Male , Adult , Cicatrix/diagnosis , Cicatrix/etiology , Cicatrix/pathology , Sarcoidosis/complications , Sarcoidosis/diagnosis , Sarcoidosis/etiology , Sarcoidosis/pathology , Lung Injury , Mediastinum/injuries , Mediastinum/pathology , Skin/injuries , Skin/pathology , Lung/pathologySubject(s)
Female , Humans , Middle Aged , Cardiomyopathy, Restrictive/pathology , Multiple Myeloma/diagnosis , Amyloidosis/diagnosis , Amyloidosis/etiology , Cardiomyopathies/diagnosis , Diagnosis, Differential , Fatal Outcome , Fabry Disease/diagnosis , Fabry Disease/etiology , Hemochromatosis/diagnosis , Hemochromatosis/etiology , Multiple Myeloma/complications , Multiple Myeloma/pathology , Proteinuria/etiology , Proteinuria/urine , Renal Insufficiency , Sarcoidosis/diagnosis , Sarcoidosis/etiologyABSTRACT
Se presenta el caso de un paciente de 26 años, con síndrome de falla cardíaca, síntomas respiratorios persistentes, fibrilación auricular y muerte súbita por taquicardia ventricular no sostenida; con evidencia ecocardiográfica de insuficiencia mitral severa y confirmación histológica e imaginológica pulmonar de sarcoidosis
Subject(s)
Sarcoidosis/complications , Sarcoidosis/diagnosis , Sarcoidosis/etiology , Sarcoidosis/therapyABSTRACT
El cáncer de células germinales de testículo es el modelo de neoplasia curable. Las complicaciones a largo plazo son bien conocidas y el seguimiento incluye la pesquisa no sólo de la recaída, sino también de la aparición de segundos tumores y secuelas del tratamiento empleado. Un aumento de la incidencia de lesiones con granulomas tipo sarcoidosis se ha descripto en las últimas dos décadas en pacientes curados quienes en el seguimiento se presentan con nódulos pulmonares o adenopatías mediastinales.Se presenta el caso clínico de un paciente de 28 años quien durante el seguimiento clínico por un tumor seminomatoso, muestra en la tomografía axial computada y radiografía de tórax la presencia de adenopatías en mediastino, sin evidencia de enfermedad en abdomen y pelvis, el otro testículo normal y marcadores negativos.Ante esta peculiar situación, se realiza mediastinoscopia diagnosticándose reacción sarcoidal en ganglio mediastinal. Durante el seguimiento de pacientes con tumores germinales de testículo la presencia de adenopatías mediastinales exige contar con el diagnóstico histológico y tener en cuenta a la sarcoidosis en el diagnóstico diferencial
Testicular germ cell tumors constitute a model for curable neoplasia. Long-term complications are well-known and follow-up includes not only awareness of relapse, but also of the development of secondary tumors and treatment sequelae. In the last two decades, an increase in sarcoidosis incidence has been described in cured patients, who at follow-up present lung nodules or mediastinal lymph nodes. A 28 year-old patient who, on clinical follow up of a seminomatous tumor, presented mediastinal lymph nodes on CT scan and chest x-ray, without evidence of disease in pelvis or abdomen is presented. His other testicle was normal and he had negative tumor markers. Because of this rare presentation, a mediastinoscopy was performed and sarcoidosis like reaction was diagnosed. During follow-up of patients with testicular germ cell tumors, the presence of mediastinal lymph nodes requires a histological diagnosis and sarcoidosis should be considered as differential diagnosis
Subject(s)
Humans , Male , Adult , Mediastinal Diseases/etiology , Sarcoidosis/etiology , Seminoma/complications , Testicular Neoplasms/complications , Diagnosis, Differential , Follow-Up Studies , Lymph Nodes/pathology , Lymphatic Metastasis/pathology , Mediastinal Diseases/pathology , Mediastinum/pathology , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/therapy , Prognosis , Sarcoidosis/pathology , Seminoma/pathology , Seminoma/therapy , Testicular Neoplasms/pathology , Testicular Neoplasms/therapy , Biomarkers, Tumor/analysisSubject(s)
Humans , Adult , Female , Cicatrix/pathology , Skin Diseases , Sarcoidosis/etiology , Sarcoidosis/immunologySubject(s)
Humans , Female , Erythema Nodosum , Lymphatic Diseases , Arthralgia , Cough , Leg/pathology , Sarcoidosis/etiology , Sarcoidosis/drug therapy , SyndromeABSTRACT
This report describes Acute Myeloid Leukemia [AML] occurring in a 46 years old woman previously diagnosed to have Sarcoidosis. There was no evidence of Sarcoidosis at the time of diagnosis of AML. Although the association is well recognized, a cause and effect relationship between the two diseases is not fully established. A brief review of the literature is presented. Case Reports: A 46 years old lady presented to the emergency room with a history of high grade fever, exertional dyspnoea and generalized weakness for the past 4 weeks. She had undergone coronary artery bypass grafting [CABG] five years back. A year before the current presentation, she had presented with a history of fever, dry cough and anorexia. Examination had been unremarkable, except for an ESR of 32 mm/hr and bilateral hilar lymphadenopathy on chest X-ray. She was treated with standard anti-tuberculosis therapy [ATT] empirically. Subsequent to a lack of response to ATT and cultures for Acid Fast Bacilli remaining negative, Angiotensin Converting Enzyme [ACE] levels were found to be elevated to 59 IU/L [normal 8-52 IU/L]. A lymph node had also appeared in the left supraclavicular region by this time; excisional biopsy of which revealed non-caseating granuloma. ATT was discontinued and the patient was started on oral steroids. Within the next two months she became asymptomatic and the chest X-ray showed a complete regression of hilar Lymph nodes. During her current admission, she was found to be febrile, pale, icteric with hepatosplenomegaly, but no lymphadenopathy Examination of the cardiovascular, respiratory and the central nervous system were unremarkable. Her laboratory data revealed a haemoglobin of 6.3 g/dl, total leukocyte count of 121x 109/L with 88% blast cells, and a platelet count of 24x109/L. Bone marrow aspirate revealed Auerrod containing blast cells which constituted 90% of the total nucleated cells. 80% of the cells showed reactivity to Sudan Black. The patient was diagnosed to have AML. The chromosomal analysis revealed a 46 XX karyotype. Serum chemistries revealed a BUN of 7 mg/dl; creatinine 1mg/dl; Na 140 mEq/L; K 2mEq/L; total bilirubin 3.6 mg/dl; ALT 11 IU/L; alkaline phosphate 52 IU/L; LDH 5487 IU/L; and uric acid 7.2 mg/dl. The ACE levels were within normal limits. The chest Xray showed evidence of previous sternotomy and no lymphadenopathy. She was started on induction chemotherapy consisting of cytosine arabinoside 100 mg/m2 for 7 days and mitoxantrone 12 mg/m2 for three days. Hematological remission was documented on the 29th day of induction treatment. Bone marrow biopsy did not reveal a granuloma or fibrosis
Subject(s)
Humans , Female , Leukemia, Myeloid, Acute/diagnosis , Sarcoidosis/complications , Sarcoidosis/diagnosis , Sarcoidosis/therapy , Sarcoidosis/etiologyABSTRACT
La sarcoidosis es una enfermedad granulomatosa sistémica caracterizada por la presencia histológica de granulomas no caseificantes. En este trabajo se ofrece una panorámica general de la enfermedad, su historia, hipótesis etiológicas, patología, inmunología y genética, cuadro clínico general y clasificación, dificultades diagnósticas y utilidad de los exámenes disponibles en la actualidad, evolución y forma de seguimiento. Por último, se expone el tratamiento con el esquema utilizado por uno de los Centros de mayor estudio de esta patología y el lugar que ocupan las drogas de segunda línea