Abstract：
:Sarcoidosis may present with musculoskeletal features or mimic rheumatic diseases. We report on a patient who had been initially diagnosed as having polymyalgia rheumatica. Because of refractory disease associated to atypical features such as severe inflammatory low back pain, dull and achy pain in the thighs, claudication of the lower limbs and bad response to corticosteroids and methotrexate (MTX), an 18F-fluorodeoxyglucosepositron emission tomography with CT (FDG PET/CT) was performed. This technique disclosed data suggestive of arteritis of large vessels involving the ascending, arch and descending aorta as well as high FDG uptake in the femoral and posterior tibial arteries of both lower extremities. Also, increased FDG uptake was observed in the right paratracheal, retrotracheal, subcarinal, gastrohepatic ligament, coeliac and right renal hilar lymph nodes. Four lymph nodes, taken during mediastinoscopy, confirmed a diagnosis of sarcoidosis. Treatment with adalimumab (40 mg every 2 weeks subcutaneously) along with prednisone and MTX was initiated yielding progressive improvement of symptoms and normalisation of laboratory abnormalities. Five months after the onset of adalimumab a new FDG PET/CT showed complete absence of uptake of lymph nodes as well as decrease of vascular FDG uptake. To our knowledge, this is the first patient treated with adalimumab because of a large-vessel vasculitis in the setting of sarcoidosis refractory to conventional therapy. This case reinforces the claim that sarcoidosis should be considered a diagnostic challenge in the assessment of patients presenting with inflammatory musculoskeletal symptoms.
journal_name
Clin Exp Rheumatoljournal_title
Clinical and experimental rheumatologyauthors
Bejerano C,Blanco R,González-Vela C,Agüero R,Carril JM,González-Gay MAsubject
Has Abstractpub_date
2012-01-01 00:00:00pages
S94-7issue
1 Suppl 70eissn
0392-856Xissn
1593-098Xpii
5362journal_volume
30pub_type
杂志文章abstract：:Systemic sclerosis remains a challenging disease despite progress that has taken place in the management of organ-based complications. Overall management strategies need to take into account the features of the disease that are common to almost all patients such as skin involvement, gastro-oesophageal manifestations a...
journal_title：Clinical and experimental rheumatology
pub_type： 杂志文章,评审
doi：
更新日期：2014-03-01 00:00:00
abstract：OBJECTIVE:To explore the main patterns of Behçet's disease (BD) expression, applying factor analysis. METHODS:Sixty-eight BD patients were studied. The following disease manifestations were used for the factor analysis: genital ulcerations, typical skin lesions (erythema nodosum, folliculitis or papulo-pustular rash),...
journal_title：Clinical and experimental rheumatology
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更新日期：1999-05-01 00:00:00
abstract：OBJECTIVE:Professional Practice Assessment (PPA) has become an obligation for all physicians in France, however its modalities remain unclear. The objective of this work was to evaluate the feasibility and accuracy of a PPA for private practice rheumatologists performed in the context of a network. METHODS:A list of i...
journal_title：Clinical and experimental rheumatology
pub_type： 杂志文章
doi：
更新日期：2008-03-01 00:00:00
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journal_title：Clinical and experimental rheumatology
pub_type： 杂志文章
doi：
更新日期：2000-03-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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更新日期：2018-03-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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更新日期：2007-05-01 00:00:00
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journal_title：Clinical and experimental rheumatology
pub_type： 临床试验,杂志文章
doi：
更新日期：1995-01-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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doi：
更新日期：2020-03-01 00:00:00
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journal_title：Clinical and experimental rheumatology
pub_type： 杂志文章
doi：
更新日期：2005-03-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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journal_title：Clinical and experimental rheumatology
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更新日期：2004-09-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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journal_title：Clinical and experimental rheumatology
pub_type： 杂志文章
doi：
更新日期：1995-07-01 00:00:00
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journal_title：Clinical and experimental rheumatology
pub_type： 杂志文章
doi：
更新日期：2019-05-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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doi：
更新日期：1995-09-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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doi：
更新日期：2018-09-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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doi：
更新日期：1990-05-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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doi：
更新日期：2020-09-01 00:00:00
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journal_title：Clinical and experimental rheumatology
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更新日期：2010-03-01 00:00:00
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doi：
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journal_title：Clinical and experimental rheumatology
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