Sarcoidosis: challenging diagnostic aspects of an old disease
Sarcoidosis: challenging diagnostic aspects of an old disease
Over the past few years, there have been substantial advances in our understanding of sarcoidosis immunopathogenesis. Conversely, the etiology of the disease remains obscure for a number of reasons, including heterogeneity of clinical manifestations, often overlapping with other disorders, and insensitive and nonspecific diagnostic tests. While no cause has been definitely confirmed, there is increasing evidence that one or more infectious agents may cause the disease, although the organism may no longer be viable. Here we present 2 cases, in which sarcoidosis preceded tuberculosis and non-Hodgkin lymphoma. Development of new lesions in a patient with chronic/remitting sarcoidosis should be looked at with suspicion and promptly investigated in order to rule out an alternative/concomitant diagnosis. In such cases, tissue confirmation from the most accessible site, and bone marrow biopsy-if lymphoma is in the differential diagnosis-should be performed. In conclusion, we strongly advise that physicians be ready to reconsider the diagnosis of sarcoidosis in the presence of atypical manifestations or persistent/progressive disease despite conventional therapy.
118-125
Spagnolo, Paolo
402ffcfa-f566-48e8-986a-5b0b2930d4ae
Luppi, Fabrizio
63b544e0-fbe9-490a-8bcd-e5452a46a234
Roversi, Pietro
bb4e8839-5d4e-436a-bec6-7a3f7cd47f8b
Cerri, Stefania
7ea9bc28-eaf2-46ce-8433-b9e732484b5f
Fabbri, Leonardo Michele
9aa89514-fe9e-4b0d-9cfc-fe019fab9672
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
February 2012
Spagnolo, Paolo
402ffcfa-f566-48e8-986a-5b0b2930d4ae
Luppi, Fabrizio
63b544e0-fbe9-490a-8bcd-e5452a46a234
Roversi, Pietro
bb4e8839-5d4e-436a-bec6-7a3f7cd47f8b
Cerri, Stefania
7ea9bc28-eaf2-46ce-8433-b9e732484b5f
Fabbri, Leonardo Michele
9aa89514-fe9e-4b0d-9cfc-fe019fab9672
Richeldi, Luca
47177d9c-731a-49a1-9cc6-4ac8f6bbbf26
Spagnolo, Paolo, Luppi, Fabrizio, Roversi, Pietro, Cerri, Stefania, Fabbri, Leonardo Michele and Richeldi, Luca
(2012)
Sarcoidosis: challenging diagnostic aspects of an old disease.
The American Journal of Medicine, 125 (2), .
(doi:10.1016/j.amjmed.2011.06.003).
(PMID:22269612)
Abstract
Over the past few years, there have been substantial advances in our understanding of sarcoidosis immunopathogenesis. Conversely, the etiology of the disease remains obscure for a number of reasons, including heterogeneity of clinical manifestations, often overlapping with other disorders, and insensitive and nonspecific diagnostic tests. While no cause has been definitely confirmed, there is increasing evidence that one or more infectious agents may cause the disease, although the organism may no longer be viable. Here we present 2 cases, in which sarcoidosis preceded tuberculosis and non-Hodgkin lymphoma. Development of new lesions in a patient with chronic/remitting sarcoidosis should be looked at with suspicion and promptly investigated in order to rule out an alternative/concomitant diagnosis. In such cases, tissue confirmation from the most accessible site, and bone marrow biopsy-if lymphoma is in the differential diagnosis-should be performed. In conclusion, we strongly advise that physicians be ready to reconsider the diagnosis of sarcoidosis in the presence of atypical manifestations or persistent/progressive disease despite conventional therapy.
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Published date: February 2012
Organisations:
Clinical & Experimental Sciences
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Local EPrints ID: 369089
URI: http://eprints.soton.ac.uk/id/eprint/369089
ISSN: 0002-9343
PURE UUID: 589cdfd2-e8c0-4b91-81aa-dcfe7fbcaec1
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Date deposited: 24 Sep 2014 12:18
Last modified: 14 Mar 2024 17:57
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Author:
Paolo Spagnolo
Author:
Fabrizio Luppi
Author:
Pietro Roversi
Author:
Stefania Cerri
Author:
Leonardo Michele Fabbri
Author:
Luca Richeldi
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