Session Type: ACR Abstract Session
Session Time: 4:30PM-6:00PM
Background/Purpose: To analyze the prevalence and characteristics of musculoskeletal sarcoidosis in a large nationwide multicenter cohort.
Methods: In January 2016, the Autoimmune Diseases Study Group (GEAS-SEMI) created a national registry (SARCOGEAS) of patients with sarcoidosis. Sarcoidosis was diagnosed in agreement with the criteria proposed by the American Thoracic Society/European Respiratory Society/World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) 1999 statement on sarcoidosis. Musculoskeletal involvement was characterized according to the 2014 WASOG organ assessment instrument, which is defined as the direct infiltrative granulomatous involvement affecting joints, bones, tendons and/or muscles (demonstrated either by imaging techniques or biopsy).
Results: Among 1521 patients included in the Registry at May 31, 2019, there were 129 (8.5%) that fulfilled the WASOG criteria for musculoskeletal sarcoidosis (72 women and 53 men, mean age at diagnosis of 45.4 years): 108 (7.1%) presented with osseous involvement and 21 (1.4%) presented with muscular sarcoidosis. Among patients presenting with osseous sarcoidosis, 24 presented typical radiological features of osseous granulomatous infiltration, 6 presented dactylitis, 25 nodular tenosynovitis and 56 asymptomatic osseous involvement demonstrated by PET/MRI: Among patients with muscular sarcoidosis, 5 presented with asymptomatic muscular involvement demonstrated by PET/MRI, 2 with palpable muscle masses, and the remaining 14 with biological/histopathological evidence of muscular involvement. In comparison with patients without musculoskeletal infiltrative involvement, those presenting with musculoskeletal sarcoidosis were predominantly White patients (96% vs 89%, p=0.025), had more frequently an acute onset of the disease (28% vs 18%, p=0.02), a higher frequency of systemic sarcoidosis (defined as the involvement of at least 2 different extrathoracic organs, 82% vs 30%, p< 0.001), a higher frequency of skin involvement (60% vs 35%, p< 0.001) and a higher frequency of need for therapy (64% vs 48%, p=0.001), including both glucocorticosteroids (61% vs 48%, p=0.007) and immunosuppressive agents (16% vs 7%, p=0.003).
Conclusion: Sarcoid musculoskeletal infiltration affects around 9% of patients with sarcoidosis, in most cases presenting as asymptomatic bone/muscular involvement demonstrated by PET, MRI and/or biopsy. These patients present with a very active systemic phenotypic profile, especially including cutaneous features, and required a more intensive systemic therapeutic approach.
To cite this abstract in AMA style:Retamozo S, Pérez-Alvarez R, Bueno Juana E, Feijoo-Massó C, González-García A, Chara-Cervantes J, Yllera Gutiérrez C, López Dupla M, Alguacil A, Rascón J, Pérez-Conesa M, Bonet M, Robles A, Callejas J, Toledo Samaniego N, Fonseca Aizpuru E, Perez Guerrero P, Garcia Morillo J, de Miguel B, Akasbi M, Tejera Pérez R, De La Red Bellvis G, Calvo Begueria E, Gómez Cerezo J, Gómez Lozano A, Gutiérrez De Ceballos E, Cruz-Caparrós G, Rodríguez Fernández S, Gato Diez A, Morcillo C, Ojeda I, Vives M, Penadés Vidal M, De Vicente M, Kostov B, Pallarés L, Brito-Zerón P, Ramos-Casals M. Musculoskeletal Sarcoidosis: Characterization and Clinical Expression of 129 Patients with Granulomatous Infiltration of Bones And/or Muscles [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/musculoskeletal-sarcoidosis-characterization-and-clinical-expression-of-129-patients-with-granulomatous-infiltration-of-bones-and-or-muscles/. Accessed June 3, 2020.
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