Clinical characteristics of patients with bone sarcoidosis

• Published in: Seminars in arthritis and rheumatism Vol. 47; no. 1; pp. 143 - 148
• Main Authors: Zhou, Ying, Lower, Elyse E., Li, Huiping, Farhey, Yolanda, Baughman, Robert P.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2017
• Subjects: Adult; Aged; Anemia - complications; Antirheumatic Agents - therapeutic use; Bone Diseases - diagnosis; Bone Diseases - physiopathology; Bone Diseases - therapy; Bone marrow; Bone Marrow Diseases - diagnosis; Bone Marrow Diseases - drug therapy; Bone Marrow Diseases - physiopathology; Bone sarcoidosis; Case-Control Studies; Disease Progression; Female; Humans; Infliximab; Infliximab - therapeutic use; Magnetic Resonance Imaging; Male; Methotrexate; Middle Aged; Positron Emission Tomography Computed Tomography; Retrospective Studies; Rheumatology; Sarcoidosis - diagnosis; Sarcoidosis - drug therapy; Sarcoidosis - physiopathology; Spine; Young Adult; Bone sarcoidosis; Bone marrow; Infliximab; Methotrexate
• ISSN: 0049-0172; 1532-866X
• DOI: 10.1016/j.semarthrit.2017.02.004

To assess the clinical features, diagnosis, and treatment of bone sarcoidosis in the United States. Patients with bone sarcoidosis were identified and matched to sarcoidosis patients based on race, gender, and age. Detailed characteristics were obtained by medical record review. A total of 64 patients with bone sarcoidosis were enrolled in this study. The female:male ratio was 1.46:1 and the white:black ratio was 3:1. Thirty-eight (59.4%) of 64 patients had bone symptoms. Compared to matched cases, bone sarcoidosis patients have more multi-organ involvement and higher incidence with liver, spleen, and extrathoracic lymph node involvement than controls (P < 0.05). Spine was the most commonly affected bone in 44 (68.8%) of patients, followed by pelvis (35.9%), and hands (15.6%). MRI and PET/CT scan was the common imaging technology, which performed in 36 patients and 32 patients, respectively, and with 97.2% and 93.8% positive bone uptake. Laboratory test indicated anemia was more common in bone sarcoidosis group than controls (P = 0.044). Infliximab was more commonly used in bone sarcoidosis patients than controls (P = 0.009). Bone sarcoidosis was associated with multi-organs affection, and high frequency of liver, spleen, or extrathoracic lymph node involvement. Infliximab should be considered in those patients with aggressive and refractory bone sarcoidosis.