Southern Clinics of Istanbul Eurasia (May 2018)

Extrapulmonary Sarcoidosis with Multiple-Organ Involvement

  • Emine Aksoy,
  • Eylem Tunçay,
  • Birsen Ocakli,
  • Sümeyye Alparslan Bekir,
  • Sinem Güngör,
  • Fatma Tokgöz Akyıl,
  • Pakize Sucu,
  • Dilek Yavuz,
  • Murat Yalçınsoy

DOI
https://doi.org/10.14744/scie.2018.42650
Journal volume & issue
Vol. 29, no. 1
pp. 30 – 35

Abstract

Read online

INTRODUCTION[|]In cases of pulmonary sarcoidosis, extrapulmonary involvement is not uncommon. The skin, eyes, and lymph nodes are the most common sites of extrapulmonary involvement, and multiple organs may be involved at the same time. In this study, patients with extrapulmonary sarcoidosis were investigated in terms of the localization of involvement.[¤]METHODS[|]Patients diagnosed with sarcoidosis between 1994 and 2015 were evaluated retrospectively. Demographic characteristics, symptoms, organ involvement, diagnostic methods, and the length of time between the diagnosis of sarcoidosis and additional organ involvement were recorded. The patients were consulted to the departments of dermatology, ophthalmology, and cardiology, and a chest X-ray, high-resolution computed tomography, and abdominal ultrasound examinations were performed.[¤]RESULTS[|]Extrapulmonary involvement was detected in 144 of a total of 337 sarcoidosis patients. In 92% of those patients with extrapulmonary involvement, there was accompanying pulmonary involvement. Women made up 75% of the group, and the mean age was 43 years. The most commonly detected extrapulmonary involvement was of the skin (n=41), followed by erythema nodosum (n=37), and involvement of the liver (n=24), lymph nodes (n=20), spleen (n=18), and salivary/parotid gland (n=15). The most frequent diagnostic method used was mediastinoscopy (n=41), followed by a skin biopsy (n=23), and a transbronchial lung biopsy (n=19). Of the 26 (18%) patients who had multiple-organ involvement, 2 were diagnosed as stage 0, 14 were stage 1, 9 were stage 2, and 1 was stage 3. The mean length of time before a diagnosis of extrapulmonary involvement was 24 days.[¤]DISCUSSION AND CONCLUSION[|]If there is extrapulmonary involvement in a case of sarcoidosis, it should be kept in mind that more than 1 organ system may be involved and the relevant additional tests may be required.[¤]

Keywords