Serum 1,25(OH)2 Vitamin D and 25(OH) Vitamin D Ratio for the Diagnosis of Sarcoidosis-Related Uveitis

Julien Rohmer¹, Jérôme Hadjadj², Amina Bouzerara³, Sawsen Salah⁴, Romain Paule⁵, Matthieu Groh⁶, Philippe Blanche⁷, Luc Mouthon⁸, Dominique Monnet⁴, Claire Le Jeunne⁹, Jean Guibourdenche¹⁰, Antoine Brezin¹¹ and Benjamin Terrier¹², ¹National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP–HP, Université Paris Descartes, Paris, Internal medicine, France, Paris, France, ²Department of Internal Medicine, National Referral Center for Rare Autoimmune and Systemic Diseases, Hospital Cochin, Assistance Publique-Hôpitaux de Paris (AP-HP), Team Neutrophils and Vasculitis, INSERM U1016, Cochin Institute, Paris, France, Paris, France, ³Service d'Hormonologie, Hôpital Cochin, Paris, France, ⁴Ophtalmology, Cochin Hospital, Paris, France, ⁵Department of Internal Medicine, Department of Internal Medicine, Cochin University Hospital, Paris, France, ⁶Internal Medicine, Foch, Suresnes, France, ⁷Internal Medicine, Cochin Hospital, Paris, France, ⁸Department of Internal Medicine, INSERM Unité 1016, Centre de Référence pour les Maladies Auto-immunes Rares, National Referral Center for Rare Systemic Autoimmune Diseases, Paris Cochin, France, Paris, France, ⁹Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, AP–HP, Université Paris Descartes, Paris, France, ¹⁰Hormonology department, Cochin Hospital, Paris, France, ¹¹Ophtalmology, Referral Center for Rare Ophthalmological Diseases, Hôpital Cochin, AP–HP, Université Paris Descartes, Paris, ophtalmology, France, Paris, France, ¹²National Referral Center for Rare Systemic Autoimmune Diseases, Paris Cochin, France, Paris, France

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: sarcoidosis and uveitis, Vitamin D

Session Information

Date: Tuesday, October 23, 2018

Session Title: Miscellaneous Rheumatic and Inflammatory Diseases Poster III: Sarcoid, Inflammatory Eye Disease, and Autoinflammatory Disease

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

The diagnostic workup of uveitis is challenging, with 30 to 50% of cases remaining of undetermined etiology despite multiple investigations. Sarcoid granuloma-related increase of 1,25(OH)₂D levels could be helpful for the diagnosis of ocular sarcoidosis.

Methods: Monocentric retrospective cohort study of patients for whom serum 25(OH)D and 1,25(OH)₂D levels were measured during the etiologic workup of unexplained uveitis in a tertiary referral center. The diagnoses of uveitis’ underlying diseases were established according to international diagnostic criteria.

Results: Fifty-nine patients were included. The diagnosis of defined, presumed or probable sarcoidosis was made in 37% of patients while 41% of cases remained of undetermined origin. The median serum levels of 25(OH)D in patients with ocular sarcoidosis and in those with uveitis due to another cause were 34.50 [21.2–40.8] and 43.20 [32.2–58.3] nmol/L (P=0.02), respectively. In the same subgroups of patients, the median serum levels of 1,25(OH)₂D were 132.4 [107.4–163.9] and 108.0 [84.30–130.5] pmol/l (P=0.02), and the median 1,25(OH)₂D/25(OH)D ratio was 4.17 [3.11–5.09] and 2.56 [1.54–3.37] (P=0.0007) respectively. A 1,25(OH)₂D/25(OH)D ratio >3.5 was associated with the diagnosis of sarcoidosis with a 68 % sensitivity and a 78% specificity and, in univariate analysis, was associated with an abnormal chest CT-scan (OR=5.7, P=0.003), granulomas on bronchial biopsy (OR=14.7, P=0.007) and bronchoalveolar lavage fluid lymphocytosis (OR=12.4, P=0.0006).

Conclusion: The measurement of serum 25(OH)D and 1,25(OH)₂D levels is a useful tool in the etiological workup of patients with unexplained uveitis, since a high 1,25(OH)₂D/25(OH)D ratio is suggestive of ocular sarcoidosis.

Disclosure: J. Rohmer, None; J. Hadjadj, None; A. Bouzerara, None; S. Salah, None; R. Paule, None; M. Groh, None; P. Blanche, None; L. Mouthon, None; D. Monnet, None; C. Le Jeunne, None; J. Guibourdenche, None; A. Brezin, None; B. Terrier, None.

To cite this abstract in AMA style:

Rohmer J, Hadjadj J, Bouzerara A, Salah S, Paule R, Groh M, Blanche P, Mouthon L, Monnet D, Le Jeunne C, Guibourdenche J, Brezin A, Terrier B. Serum 1,25(OH)2 Vitamin D and 25(OH) Vitamin D Ratio for the Diagnosis of Sarcoidosis-Related Uveitis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/serum-125oh2-vitamin-d-and-25oh-vitamin-d-ratio-for-the-diagnosis-of-sarcoidosis-related-uveitis/. Accessed September 19, 2021.

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