[The importance of hypercalciuria in assessing the clinical course and treatment modalities of sarcoidosis].

INTRODUCTION: In patients with sarcoidosis high levels of Ca2+ in blood serum accompanied by increased 24-hour urinary calcium are of great diagnostic and prognostic value. High levels of these two important parameters may point to hyperparathyroidism and/or chronic sarcoidosis. It is necessary to exclude kidney insufficiency by kidney ultrasound. MATERIAL AND METHODS: During the previous four years (1999-2003), urinary Ca was significantly higher than the physiological level in 25 patients, whereas the blood serun Ca was normal. 18 patients received corticosteroid therapy (40 mg for two months, and 35 mg later on). Patients with acute sarcoidosis received prednisone for 11.8 months, while patients with chronic sarcoidosis received it for 13.6 months. One patient with chronic sarcoidosis received methotrexate, as alternative therapy. RESULTS: 4 months later, after normalization of urinary Ca excretion, the follow-up of patients revealed only one patient with increased urinary Ca excretion associated with increased ACE and radiographic progression of the disease.

[The role of EQ5D self-classifier in assessing quality of life in patients with sarcoidosis].

INTRODUCTION: In medicine, quality of life is a very important issue. Nowdays, in our circumstances, it is an important part of diagnostic and therapeutic procedures. The aim of this study was to analyze the role of EQ5D questionnaire in patients with sarcoidosis. MATERIAL AND METHODS: EQ5D self-questionnaire was used in patients with sarcoidosis and we analyzed the obtained data. RESULTS: The analysis included patients with previously proved sarcoidosis--pulnmonary and extrapulmonary (bronchoscopy and other biopsies). All patients were treated at the Institute of Tuberculosis and Lung Diseases. We analyzed a group of 84 (19 male and 65 female) patients with average age of 45 years. Most patients had a chronic state of disease and were nonsmokers. In regard to the radiographic stage of pulmonary sarcoidosis, levels of disease activity (acute, chronic and relapse), levels of sACE, levels of sIgE, smokers--non smokers, and in regard to obtained scores, no statistically significant difference was found in examined groups, except in the group of patients with low level sIgE (score 0.276). CONCLUSION: EQ5D questionnaire is a good tool for analyzing the health status of patients with sarcoidosis, but still a more specific questionnaire should be designed for this multisystem disease.

[Rare forms of panniculitis: subcutaneous sarcoidosis and panniculitis associated with dermatomyositis]. / Retke forme panikulitisa: supkutana sarkoidoza i panikulitis u sklopu dermatomiozitisa.

Panniculitides represent heterogenous group of disorders involving subcutaneous fat tissue, and are etiologically related to different causes, including systemic diseases. Two female patients having subcutaneous sarcoidosis and panniculitis associated with dermatomyositis are presented in this paper. The first patient, (38 years of age), was with the nodes on forearms and lower legs, which occurred one month after hypophysectomy for adrenocorticoscopic (ACTH)-secreting pituitary adenoma, and showed histopathologically confirmed epithelioid, noncaseating granulomas in the subcutaneous fat tissue. Laboratory and radiographic findings were normal, with the exception of positive rheumatoid factor and incompletely developed cysts in proximal phalanges of the hand. The second patient (56 years of age), was with subcutaneous nodes on the upper arm and the lateral chest wall, which were noticed several months after the diagnosis of dermatomyositis. Histopathological examination showed lobular pannicilitis with hyaline fibrosis and plasmocytic-lymphocytic infiltrate.