Camille Febvay1, Laurent Kodjikian1, Delphine Maucort-Boulch2, Laurent Perard3, Jean Iwaz2, Yvan Jamilloux4, Christiane Broussolle4, Carole Burillon5, Pascal Seve4. 1. Department of Ophthalmology, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France University Claude Bernard Lyon 1, Villeurbanne, France. 2. University Claude Bernard Lyon 1, Villeurbanne, France Service de Biostatistique, Hospices Civils de Lyon, Lyon, France Université de Lyon, Lyon, France UMR5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biostatistique-Santé, CNRS, Villeurbanne, France. 3. University Claude Bernard Lyon 1, Villeurbanne, France Department of Internal Medicine, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France. 4. University Claude Bernard Lyon 1, Villeurbanne, France Department of Internal Medicine, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France. 5. University Claude Bernard Lyon 1, Villeurbanne, France Department of Ophthalmology, Hôpital Edouard Herriot, Hospices Civils de Lyon, Lyon, France.
Abstract
AIMS: To determine the clinical features of patients with uveitis with biopsy-proven sarcoidosis, document differences in these features according to ethnicity, age and sex, and assess the diagnostic value of biochemical and imaging examinations. METHODS: Retrospective study of 83 biopsy-proven sarcoid uveitis cases seen at two Departments of Internal Medicine and two Departments of Ophthalmology between April 2004 and March 2014. RESULTS: Caucasian patients presented with uveitis at a later age than non-Caucasian (58 years vs 41 years; p=0.001) and had more often a chronic form (78.3% vs 43.8%; p=0.01). Women had higher rates of chronic macular oedema than men (48.3% vs 14.3%; p=0.01). There were no statistically significant differences between patients aged ≤50 years and patients aged >50 years. ACE levels were high (>62 U/L) in 61.7% and lysozyme levels high (>16.7 mg/L) in 83.9% of tested patients. Chest X-rays and CTs were suggestive of sarcoidosis in 62.8% and 91.2% of cases, respectively. Among 21 patients with positive tomography and negative X-rays, 13 were Caucasian women >50 years. Endoscopic ultrasound-guided fine-needle aspiration of intrathoracic nodes contributed to the diagnosis in 7 patients with normal labial salivary gland and transbronchial biopsies. Any of the enzyme tests together with any of the imaging tests identified 100% of the patients. CONCLUSIONS: In this largest European series of biopsy-proven sarcoidosis to date, the outstanding diagnostic ability of enzyme test plus imaging test couple suggests that the recourse to invasive procedures should be limited to patients with ocular involvement that would justify systemic treatments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
AIMS: To determine the clinical features of patients with uveitis with biopsy-proven sarcoidosis, document differences in these features according to ethnicity, age and sex, and assess the diagnostic value of biochemical and imaging examinations. METHODS: Retrospective study of 83 biopsy-proven sarcoid uveitis cases seen at two Departments of Internal Medicine and two Departments of Ophthalmology between April 2004 and March 2014. RESULTS: Caucasian patients presented with uveitis at a later age than non-Caucasian (58 years vs 41 years; p=0.001) and had more often a chronic form (78.3% vs 43.8%; p=0.01). Women had higher rates of chronic macular oedema than men (48.3% vs 14.3%; p=0.01). There were no statistically significant differences between patients aged ≤50 years and patients aged >50 years. ACE levels were high (>62 U/L) in 61.7% and lysozyme levels high (>16.7 mg/L) in 83.9% of tested patients. Chest X-rays and CTs were suggestive of sarcoidosis in 62.8% and 91.2% of cases, respectively. Among 21 patients with positive tomography and negative X-rays, 13 were Caucasian women >50 years. Endoscopic ultrasound-guided fine-needle aspiration of intrathoracic nodes contributed to the diagnosis in 7 patients with normal labial salivary gland and transbronchial biopsies. Any of the enzyme tests together with any of the imaging tests identified 100% of the patients. CONCLUSIONS: In this largest European series of biopsy-proven sarcoidosis to date, the outstanding diagnostic ability of enzyme test plus imaging test couple suggests that the recourse to invasive procedures should be limited to patients with ocular involvement that would justify systemic treatments. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: Patompong Ungprasert; Andrea A Tooley; Cynthia S Crowson; Eric L Matteson; Wendy M Smith Journal: Ocul Immunol Inflamm Date: 2017-10-12 Impact factor: 3.070
Authors: Margarita Oks; Albert Li; Mina Makaryus; Howard D Pomeranz; Mala Sachdeva; James Pullman; Dan Schwartz; Harry Steinberg Journal: Respir Med Case Rep Date: 2018-03-03