%0 Journal Article
%T The Prevalence of Sacroiliitis and Spondyloarthritis in Patients with Sarcoidosis
%A Senol Kobak
%A Fidan Sever
%A Ozlem Ince
%A Mehmet Orman
%J International Journal of Rheumatology
%D 2014
%I Hindawi Publishing Corporation
%R 10.1155/2014/289454
%X Introduction. Sarcoidosis is a chronic granulomatous disease, which can involve different organs and systems. Coexistence of sarcoidosis and spondyloarthritis has been reported in numerous case reports. Purpose. To determine the prevalence of sacroiliitis and spondyloarthritis in patients previously diagnosed with sarcoidosis and to investigate any possible relation with clinical findings. Materials and Methods. Forty-two patients with sarcoidosis were enrolled in the study. Any signs and symptoms in regard to spondyloarthritis (i.e., existence of inflammatory back pain, gluteal pain, uveitis, enthesitis, dactylitis, inflammatory bowel disease, and psoriasis) were questioned in detail and biochemical tests were evaluated. Sacroiliac joint imaging and lateral heel imaging were performed in all patients. Results. Sacroiliitis was found in 6 of the 42 (14.3%) sarcoidosis patients and all of these patients were female. Common features of the disease in these six patients were inflammatory back pain as the major clinical complaint, stage 2 sacroiliitis as revealed by radiological staging, and the negativity of HLA B-27 test. These six patients with sacroiliitis were diagnosed with spondyloarthritis according to the criteria of ASAS and of ESSG. Conclusion. We found spondyloarthritis in patients with sarcoidosis at a higher percentage rate than in the general population (1¨C1.9%). Controlled trials involving large series of patients are required for the confirmation of the data. 1. Introduction Sarcoidosis is a systemic disease characterized by the involvement of multiple tissues and organs with a noncalcified granuloma reaction, which is not yet well understood [1]. Although the exact pathogenesis of sarcoidosis is not known, it is currently accepted that, in genetically susceptible individuals, it is caused through alteration of the cellular immune response after exposure to an environmental, occupational, or infectious agent [2]. Accumulations of Th1 and macrophages with increased production of proinflammatory cytokines induce the inflammatory cascade and consecutive impairment in tissue permeability; increase in cellular influx and local cellular proliferation cause the formation of granulomas [3]. The crucial pathological finding of sarcoidosis is noncalcified epitheloid cellular granulomas [4]. Sarcoidosis is a chronic granulomatous disease that may present with various clinical findings. It may mimic a number of primary rheumatic diseases and/or accompany them [5]. The disease most frequently presents with bilateral hilar lymphadenopathy and
%U http://www.hindawi.com/journals/ijr/2014/289454/