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Abstract Number: 2266

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

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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 9). https://acrabstracts.org/abstract/serum-125oh2-vitamin-d-and-25oh-vitamin-d-ratio-for-the-diagnosis-of-sarcoidosis-related-uveitis/. Accessed January 30, 2023.
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