Sarcoidosis Vasc Dif
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Sarcoidosis Vasc Dif · Jun 2003
Misdiagnosis of sarcoidosis in patients with chronic beryllium disease.
Sarcoidosis (SA) is a chronic systemic disorder characterized by infiltration of inflammatory cells in affected organs, resulting in the formation of granulomas. Granulomas are observed in numerous infectious diseases and hypersensitivity reactions (e.g., beryllium). Chronic beryllium disease (CBD) is a multisystem entity caused by dust, fumes or mists of beryllium metal or its salts. Although beryllium has been used for years by several industries in Israel, no case of CBD had ever been reported until recently when we described a 21-year-old female dental technician with CBD who was originally diagnosed as having SA. We launched the current investigation to test the hypothesis that other cases of CBD in Israel were not previously reported because these patients were misdiagnosed as having SA. ⋯ Our findings emphasize the vital importance of taking a comprehensive occupational history in the clinical evaluation of patients suspected of having SA.
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Although the lung is the primary target of involvement, sarcoidosis can involve any organ in the body, including the eye. Ocular involvement may also be the initial manifestation of sarcoidosis in many patients. ⋯ This review discusses ocular manifestations and changes based upon the anatomic site of the eye, ocular tissue biopsy, and treatment. Early recognition and intervention are essential for the reduction of ocular morbidity and the improvement of the patient's quality of life.
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To redefine the utility of CSF-ACE as a selective indicator of probable CNS neurosarcoidosis. ⋯ CSF-ACE activity is a useful biochemical marker of probable CNS neurosarcoidosis when brain and/or spinal cord MRI show diffuse enhancing lesions.
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Sarcoidosis Vasc Dif · Mar 2002
ReviewHistopathological approach to patterns of interstitial pneumonia in patient with connective tissue disorders.
It is well established that some patients with connective tissue disorders will suffer from pulmonary disease at some stage in their disease progression. This article concentrates on the interstitial pneumonias, seen in association with most types of connective tissue disorder, particularly in the ligh of non-specific interstitial pneumonia (NSIP) being recognised as a distinct histological pattern. Most published articles on this subject precede recognition of NSIP and, as such, the relative incidence of patterns of interstitial pneumonia, as defined by the International Consensus Classification Committee for Interstitial Lung Disease (ICCILD), as well as the clinical and prognostic significance of these patterns is undergoing further scrutiny. ⋯ The histological pattern of usual interstitial pneumonia, the most frequently seen pattern in biopsies from patients with idiopathic pulmonary fibrosis/cryptogenic fibrosing alveolitis, appears to be comparatively rare. Furthermore, any biopsy showing a combination of histological patterns, a pattern of non-specific interstitial pneumonia or a pattern of lymphoid interstitial pneumonia/follicular bronchiolitis should be thoroughly investigated for a background connective tissue disorder, if previously unsuspected. Finally, the recently published prognostic data relating to these histological patterns in idiopathic disease should not be extrapolated to patients with connective tissue disorders.
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Sarcoidosis Vasc Dif · Oct 2001
Evidence for disease phenotype associated haplotypes (DR.TNF) in sarcoidosis.
In a previous study, gene polymorphisms of the MHC locus (-308 TNFalpha promotor, HLA-DR) in patients with pulmonary sarcoidosis had been investigated and significant correlations with the presentation of the disease as defined by the presence of Löfgren syndrome had been found. Since genotyping of both loci was necessary to reveal a significant difference on the genetic level between the two patient groups Löfgren and non-Löfgren, a working hypothesis was derived in which a disease course associated haplotype, rather than single specific genes, was considered to play a role in the pathogenesis of sarcoidosis. ⋯ Using theoretical calculations based on actual data, haplotypes, rather than single genes interacting with each other, were found to be a highly likely explanation for the previously published observations. In addition, the results allow the conclusion to be drawn that disease course associated haplotypes in sarcoidosis are highly probable and that further investigation of polymorphisms in the MHC gene region holds the potential of defining prognostic markers.