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Abstract Number: 907

Musculoskeletal Sarcoidosis: Characterization and Clinical Expression of 129 Patients with Granulomatous Infiltration of Bones And/or Muscles

Soledad Retamozo1, Roberto Pérez-Alvarez 2, Esperanza Bueno Juana 3, Carlos Feijoo-Massó 4, Andrés González-García 5, Joel Chara-Cervantes 6, Carmen Yllera Gutiérrez 7, Miguel López Dupla 8, Ana Alguacil 9, Javier Rascón 10, Mercedes Pérez-Conesa 6, Mariona Bonet 11, Angel Robles 12, José Luis Callejas 13, Neera Toledo Samaniego 14, Eva Fonseca Aizpuru 15, Patricia Perez Guerrero 16, Jose Salvador Garcia Morillo 17, Borja de Miguel 18, Miriam Akasbi 19, Rosa Tejera Pérez 20, Gloria De La Red Bellvis 21, Eva Calvo Begueria 22, Jorge Francisco Gómez Cerezo 23, Albert Gómez Lozano 24, Enrique Peral Gutiérrez De Ceballos 25, Gracia Cruz-Caparrós 26, Sergio Rodríguez Fernández 27, Alberto Gato Diez 28, César Morcillo 29, Inmaculada Ojeda 30, M José Vives 31, María Penadés Vidal 32, Moisés De Vicente 33, Belchin Kostov 34, Lucio Pallarés 10, Pilar Brito-Zerón 35 and Manuel Ramos-Casals 36, 1Instituto De Investigaciones En Ciencias De La Salud, Univ. Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba, Argentina., Cordoba, Argentina, 2Department of Internal Medicine, Hospital Alvaro Cunqueiro, Vigo, Spain., Vigo, Spain, 3Hospital Clínico, Zaragoza, Spain, Zaragoza, Spain, 4Hospital Parc Tauli, Sabadell, Sabadell, Spain, 5Hospital Ramon y Cajal, Madrid, Spain, Madrid, Spain, 6Hospital Universitario Miguel Servet, Zaragoza, Spain, Zaragoza, Spain, 7Department of Internal Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain, Oviedo, Spain, 8Systemic Autoimmune Diseases Unit, Hospital Joan XXIII, Tarragona, Spain., Tarragona, Spain, 9Hospital Virgen de la Salud, Toledo, Spain, Toledo, Spain, 10Hospital Son Espases, Palma de Mallorca, Spain, Palma de Mallorca, Spain, 11Department of Internal Medicine, Althaia, Xarxa Assistencial de Manresa, Spain, Manresa, Spain, 12Hospital La Paz, Madrid, Spain, Madrid, Spain, 13Hospital Clínico San Cecilio, Granada, Spain, Granada, Spain, 14Systemic Autoimmune Diseases Unit Medicine, Hospital Gregorio Marañón, Madrid, Spain, Madrid, Spain, 15Department of Internal Medicine, Hospital de Cabueñes, Gijón, Spain, Gijón, Spain, 16Department of Internal Medicine, Hospital Universitario Puerta del Mar, Cádiz, Spain, Cadiz, Spain, 17Department of Internal Medicine, Hospital Virgen del Rocio, Sevilla, Spain, Sevilla, Spain, 18Hospital 12 de Octubre, Madrid, Spain, Madrid, Spain, 19Hospital Infanta Leonor, Madrid, Madrid, Spain, 20Department of Internal Medicine, Hospital Clínico Universitario de Salamanca-IBSAL. Salamanca, Spain, Salamanca, Spain, 21Department of Internal Medicine, Hospital de Santa Coloma de Gramanet, Barcelona, Spain, Barcelona, Spain, 22Hospital Universitario Puerta del Mar, Cádiz, Spain, Cadiz, Spain, 23Hospital Infanta Sofía, Madrid, Spain, Madrid, Spain, 24Hospital de Sta Caterina, Girona, Spain, Girona, Spain, 25Department of Internal Medicine, Hospital Virgen Macarena, Sevilla, Spain, Sevilla, Spain, 26Department of Internal Medicine, Hospital de Poniente El Ejido, Almería, Spain, Almeria, Spain, 27Department of Internal Medicine, Hospital da Barbanza, A Coruña, Spain, A Coruña, Spain, 28Department of Internal Medicine, Complejo Hospitalario Albacete, Spain, Albacete, Spain, 29Systemic Autoimmune Diseases Unit, Hospital CIMA-Sanitas, Barcelona, Spain, Barcelona, Spain, 30Department of Internal Medicine, Hospital Valle del Guadiato, Córdoba, Spain, Cordoba, Spain, 31Parc Sanitari San Joan de Déu, Sant Boi, Barcelona, Spain, Barcelona, Spain, 32Department of Internal Medicine, Hospital De Manises, Valencia, Spain, Valencia, Spain, 33Department of Internal Medicine, Hospital Nuestra Señora del Prado, Talavera, Spain, Talavera, Spain, 34Primary Healthcare Transversal Research Group, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS). Primary Care Centre Les Corts, Consorci d’Atenció Primària de Salut Barcelona Esquerra (CAPSBE). Department of Statistics and Operations Research, Universitat Politècnica de Catalunya, Barcelona, Spain., Barcelona, Spain, 35Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX, Department of Autoimmune Diseases, ICMiD, University of Barcelona, Hospital Clínic. Autoimmune Diseases Unit, Department of Medicine, Hospital CIMA- Sanitas, Barcelona, Spain., Barcelona, Spain, 36Department of Autoimmune Diseases, ICMiD. Sjögren Syndrome Research Group (AGAUR), Laboratory of Autoimmune Diseases Josep Font, IDIBAPS-CELLEX. Department of Medicine, University of Barcelona, Hospital Clínic, Barcelona, Spain., Barcelona, Spain

Meeting: 2019 ACR/ARP Annual Meeting

Keywords: Clinical and Musculoskeletal, sarcoidosis

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Session Information

Date: Sunday, November 10, 2019

Session Title: 3S104: Miscellaneous Rheumatic & Inflammatory Disease I: Expanding the Spectrum of Clinical Features in Rheumatological Disorders (903–908)

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.


Disclosure: S. Retamozo, None; R. Pérez-Alvarez, None; E. Bueno Juana, None; C. Feijoo-Massó, None; A. González-García, None; J. Chara-Cervantes, None; C. Yllera Gutiérrez, None; M. López Dupla, None; A. Alguacil, None; J. Rascón, None; M. Pérez-Conesa, None; M. Bonet, None; A. Robles, None; J. Callejas, None; N. Toledo Samaniego, None; E. Fonseca Aizpuru, None; P. Perez Guerrero, None; J. Garcia Morillo, None; B. de Miguel, None; M. Akasbi, None; R. Tejera Pérez, None; G. De La Red Bellvis, None; E. Calvo Begueria, None; J. Gómez Cerezo, None; A. Gómez Lozano, None; E. Gutiérrez De Ceballos, None; G. Cruz-Caparrós, None; S. Rodríguez Fernández, None; A. Gato Diez, None; C. Morcillo, None; I. Ojeda, None; M. Vives, None; M. Penadés Vidal, None; M. De Vicente, None; B. Kostov, None; L. Pallarés, None; P. Brito-Zerón, None; M. Ramos-Casals, None.

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 January 27, 2023.
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