Assuntos
Artrite Reumatoide/complicações , Articulação Esternoclavicular , Cisto Sinovial/etiologia , Artrite Reumatoide/diagnóstico por imagem , Humanos , Masculino , Pessoa de Meia-Idade , Articulação Esternoclavicular/diagnóstico por imagem , Cisto Sinovial/diagnóstico por imagem , Tomografia Computadorizada por Raios XAssuntos
Anticorpos Anti-Idiotípicos/análise , Anticorpos Monoclonais/uso terapêutico , Artrite Reumatoide/imunologia , Síndrome de Behçet/imunologia , Fator de Necrose Tumoral alfa/imunologia , Corticosteroides/uso terapêutico , Adulto , Anticorpos Anti-Idiotípicos/imunologia , Antirreumáticos/uso terapêutico , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Síndrome de Behçet/complicações , Síndrome de Behçet/tratamento farmacológico , Biomarcadores/análise , Quimioterapia Combinada , Humanos , Infliximab , Masculino , Prognóstico , Índice de Gravidade de Doença , Falha de Tratamento , Resultado do TratamentoRESUMO
OBJECTIVE: To evaluate asymptomatic gastrocnemius muscle biopsy as a tool in the histologic confirmation of the diagnosis of sarcoidosis. METHODS: Twenty-two patients admitted over a 2-year period to our department with bilateral hilar adenopathy and a variety of symptoms compatible with sarcoidosis were studied prospectively. Besides a complete history and physical, serum angiotensin converting enzyme (SACE) determination, pulmonary function, slit lamp eye examination, PPD skin test, gallium 67 scan and gastrocnemius muscle biopsy were performed. RESULTS: The biopsy revealed non-caseating granuloma in all patients, confirming the diagnosis of sarcoidosis. No other patient in our department received this diagnosis over the 2-year period of the study. The procedure was well tolerated by all patients and almost zero morbidity was noted. Erythema nodosum was present in 68.2% of the patients, PPD was negative in all of them, SACE was elevated in 59.1% and pulmonary function was normal in the majority. CONCLUSION: The impressive sensitivity of asymptomatic gastrocnemius muscle biopsy, its safety and ease of performance, along with the extreme rarity of muscle involvement by other granulomatous diseases included in the differential diagnosis, may render it the procedure of choice for the histologic confirmation of sarcoidosis presenting with hilar adenopathy.