Can Sarcoidosis Cause Autoamputation of a Finger Phalanx?

The Surgery Journal, 2017

Sarcoidosis is an idiopathic, noncaseating granulomatous disorder with wide systemic involvement. It is encountered widely around the world and it affects both sexes, all the races in all age groups. Lungs, eyes, and skin are the organs most commonly affected. Constitutional features such as weight loss, fatigue, and myalgia are the most common symptoms. Bone involvement, which is very rare, was reported as present in 3 to 13% of effected cases, and it is most commonly seen in hands and feet, compared with long bone involvement, which is extremely rare. We hereby present a case with a diagnosis of sarcoidosis and multiple bone involvement emphasizing the importance of differential diagnosis.

Shortness of Breath, 2015

Sarcoidosis is a multisystem disease of unknown etiology characterized by clusters of non-necrotizing granulomas and distortion of surrounding tissue. Although some patients are asymptomatic, sarcoidosis can cause a wide range of signs and symptoms often mimicking autoimmune rheumatologic disorders. Combined sarcoidosis and autoimmune disorders is uncommon as a result of either an University Hospital database analysis and literature review. However, given the high prevalence of autoimmunity in the general population, clinicians should be alerted to correctly diagnose and manage patients suspected to have both sarcoidosis and autoimmune disorders.

Sarcoidosis is a multi-system granulomatous diseases of undetermined etiology characterized by activation of lymphocytes and mononuclear phagocytes at the site of the disease (I). Seen most often between 30-40 years of age, it can effect any race, though less common in tropics. It involves lungs in 80-90% of cases (2), although it is a multi-organ disease and can present to any of the medical or surgical discipline (3). In areas endemic for Tuberculosis like Pakistan there may be lot of difficulty in excluding Mycobacterial infection, since both the diseases have similar clinico-radiological, biochemical and pathological features (4). Clinical and epidemiological features favor the hypothesis that it results from environmental exposure. possibly infective agents. An updated review of the subject is presented.

Reumatología Clínica, 2017

A 35-year-old man presented with a 3-year history of arthralgia and purple coloration of the skin of his fingers and feet. Hand and foot radiography showed cystic bone lesions on phalanges suggestive of sarcoidosis. Lab tests revealed increased liver enzymes. Liver MRI evidenced an enlarged liver and retroperitoneal lymphadenopathy. Histological analysis of the finger skin, lymph nodes and liver demonstrated the presence of granulomas, confirming the diagnosis of sarcoidosis. The patient started prednisolone with rapid improvement of the symptoms. Skin lesions are divided into two groups: specific for sarcoidosis (with granulomas, lupus pernio-like) and nonspecific (without granulomas, erythema nodosum-like). Specific cutaneous lesions usually cause no other symptoms beyond cosmetic changes. Lupus pernio stands out for having distinctive features but, to the best of our knowledge, the simultaneous involvement of both hands and feet has never been reported.

Seminars in Arthritis and Rheumatism, 1987

ARCOIDOSIS is a multisystem granulomatous disorder of uncertain etiology most often affecting young adults and presenting commonly with bilateral hilar lymphadenopathy, pulmonary infiltration, and skin or eye lesions. Other organs involved include peripheral lymph nodes, liver, spleen, parotid glands, bones, heart, nervous system, and muscles.' Myopathy, first described by Myers et al in 19.52,' is rare. Symptomatic patients typically have a chronic, slowly progressive muscle disease, often with wasting, and closely resembling chronic polymyositis or muscular dystrophy.3 Other symptomatic forms include palpable muscle nodules and acute myositis. The myopathy may occur with other organ involvement or be isolated. However, asymptomatic muscular involvement is probably more common than any of the forms described above, and is thought to occur in 50% to 80% of sarcoidosis cases4 In this report, we describe the clinical course and muscle pathology in four patients with sarcoidosis and muscle weakness and review the medical literature of previously reported cases of sarcoid myopathy. PATIENTS AND METHODS A medical records review enabled us to identify all adult patients discharged from Baptist Memorial Hospital (Memphis) with a diagnosis of sarcoidosis or polymyositis during the years 1980 through 1985. A 36-item database including demographic information, symptoms and signs of myopathy with or without skin involvement, electromyography-nerve conduction velocity (EMG-NCV) studies, muscle enzyme levels, and the results of muscle biopsies where available, was

Journal of the Neurological Sciences, 2017

received and the evolutionary profile. The statistical analysis was carried out using the Excel software. Results: Thirty patients admited between 2005 and 2016. 3 patients had a diagnosis of NS definite, 17 probable, and 10 possible. The average age was 45 years and 63% were females. Neurological signs revealed sarcoidosis in 28 patients, dominated by brain localization in 20 patients, followed by medullary involvement, cranial nerves, muscle and peripheral nerves. 24 patients received corticosteroids, 3 cases of death and 8 cases of total improvement. Conclusion: NS is a difficult diagnosis when neurological involvement is inaugural. It worsen the prognosis and prompts a rapid use of immunosuppressants.

The annals of clinical and analytical medicine, 2024

Hand bony involvement of sarcoidosis Rare case of hand bony involvement of sarcoidosis in a palestinian woman: A case report

Clinics in Chest Medicine, 2008

Journal of Nepal Medical Association, 2007

Sarcoidosis is a multi system disorder of unknown cause most commonly affecting the young and middle age adults and frequently presents bilateral hilar lymph-adenopathy. The diagnosis of sarcoidosis is often delayed following the onset of symptoms. The reason being first, the disease is often sub clinical; second as the disease affects any system, the diagnosis of sarcoidosis may not be considered; third, the symptoms are not disease specific hence often treated as other chronic pulmonary diseases; finally economic issues or barriers to access for further workup may affect the timeliness of the diagnosis. No laboratory diagnosis is specific for diagnosing sarcoidosis but histological confirmation from the lymph nodes accessible for biopsy either direct or by intervention may be more specific.

Cureus, 2023

Sarcoidosis is a systemic disease of unknown etiology with multi-system affection. It typically involves the skin, eyes, hilar lymph nodes, and pulmonary parenchyma. However, as any organ system could be involved, one has to be aware of its atypical manifestations. We present three uncommon manifestations of the disease. Our first case presented with fever, arthralgias, and right hilar lymphadenopathy with a history of tuberculosis in the past. He was treated for tuberculosis but had a relapse of symptoms three months after completion of treatment. The second patient presented with a headache for two months. On evaluation, cerebrospinal fluid examination showed evidence of aseptic meningitis, while an MRI of the brain demonstrated enhancement of the basal meninges. The third patient was admitted with a mass on the left side of the neck for one year. On evaluation, he was found to have left cervical lymphadenopathy, with its biopsy showing non-caseating epitheloid granuloma. Immunofluorescence did not show evidence of leukemia or lymphoma. All the patients had negative tuberculin skin tests and elevated serum angiotensinconverting enzyme levels supporting the diagnosis of sarcoidosis. They were treated with steroids with complete resolution of symptoms and no recurrence at follow-up. Sarcoidosis is an underdiagnosed entity in India. Thus, awareness of the atypical clinical features could lead to early recognition of the disease and its treatment.