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Association of peripheral multifocal choroiditis with sarcoidosis: A study of thirty‐seven patients

Arthritis and rheumatism, 2004-12, Vol.51 (6), p.974-982 [Peer Reviewed Journal]

Copyright © 2004 by the American College of Rheumatology ;ISSN: 0004-3591 ;EISSN: 1529-0131 ;DOI: 10.1002/art.20839 ;PMID: 15593175

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Title:
Association of peripheral multifocal choroiditis with sarcoidosis: A study of thirty‐seven patients
Author: Abad, S. ; Meyssonier, V. ; Allali, J. ; Gouya, H. ; Giraudet, A. L. ; Monnet, D. ; Parc, C. ; Tenenbaum, f. ; Alberini, J. L. ; Grabar, S. ; Pesce, F. ; Rollot, F. ; Sicard, D. ; Dhote, R. ; Blanche, P. ; Brézin, A. P.
Subjects: Adult ; Aged ; Aged, 80 and over ; Choroiditis - complications ; Choroiditis - drug therapy ; Choroiditis - pathology ; Female ; Fluorescein Angiography ; Gallium ; Gallium scintigraphy ; Humans ; Macular Edema - drug therapy ; Macular Edema - etiology ; Macular Edema - pathology ; Male ; Methotrexate ; Methotrexate - therapeutic use ; Middle Aged ; Peripheral multifocal choroiditis ; Radionuclide Imaging ; Retrospective Studies ; Sarcoidosis ; Sarcoidosis, Pulmonary - complications ; Sarcoidosis, Pulmonary - diagnostic imaging ; Sarcoidosis, Pulmonary - pathology ; Tomography, X-Ray Computed
Is Part Of: Arthritis and rheumatism, 2004-12, Vol.51 (6), p.974-982
Description: Objective To assess the clinical spectrum of peripheral multifocal choroiditis (PMC) and its association with sarcoidosis. Methods Thirty‐seven patients examined between November 1997 and November 2001 who met all diagnostic criteria for PMC were included in this retrospective study. Patients were assessed for the following signs of sarcoidosis: typical changes on chest radiography or computed tomography; predominantly CD4 lymphocytosis in bronchoalveolar lavage fluid; elevated serum angiotensin‐converting enzyme levels; elevated gallium uptake; and noncaseating granuloma on biopsy. Results Most of the patients were female (30 of 37; 81%) and white (30 of 37; 81%). Mean ± SD age at onset was 57.5 ± 18.7 years. Seven (19%) of the 37 patients had biopsy‐proven sarcoidosis and 18 patients (49%) with presumed sarcoidosis met at least 2 of the above‐mentioned criteria for sarcoidosis but had normal biopsy results. Twelve patients (32%) had an indeterminate diagnosis. Patients with presumed sarcoidosis did not differ from those with proven sarcoidosis as regards the above‐mentioned criteria, except for noncaseating granuloma, implying that more than two‐thirds of patients (predominantly whites) had underlying sarcoidosis. Most patients with positive gallium scintigraphy had increased mediastinal uptake, as described in sarcoidosis. Patients with underlying sarcoidosis had more severe visual impairment due to cystoid macular edema (CME). Weekly methotrexate (0.3 mg/kg) seemed to control CME. Conclusion White patients with PMC should be considered to have sarcoidosis. The identification of sarcoidosis in patients with severe ocular disease can help with therapeutic choices.
Publisher: Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Language: English
Identifier: ISSN: 0004-3591
EISSN: 1529-0131
DOI: 10.1002/art.20839
PMID: 15593175
Source: MEDLINE
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Association of peripheral multifocal choroiditis with sarcoidosis: A study of thirty‐seven patients

Copyright © 2004 by the American College of Rheumatology ;ISSN: 0004-3591 ;EISSN: 1529-0131 ;DOI: 10.1002/art.20839 ;PMID: 15593175

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