• 作者：M.N. Requeno-Jarabo ; R. Amor¨®s-Garc¨ªa ; I.I. Murillo-D¨ªaz de Cerio ; A. Anto?anzas-Lombarte
• 关键词：Sarcoidosis ; Artralgia ; Nó ; dulos linfá ; ticos
• 刊名：SEMERGEN - Medicina de Familia
• 出版年：2013
• 出版时间：September, 2013
• 年：2013
• 卷：39
• 期：6
• 页码：325-329
• 全文大小：760 K

A 39 year-old patient consulted his family doctor due to migratory polyarthralgia, with C-reactive protein 7.99 mg/dl, ESR 89 mm and normal anti-streptolysin O (ASO).

A sample was taken for analysis in the Rheumatology Clinic: ACE 72 IU, with normal rheumatoid factor, C-reactive protein and ASO; HLA non-specific. Chest X-ray showed an increased pulmonary interstitial pattern, and his chest-CT showed multiple bilateral pulmonary nodules and mediastinal lymph nodes. A differential diagnosis of lymphoproliferative process was considered. A gallium scintigraphy was performed with no relevant findings. The patient was referred to Thoracic Surgery for a lymph node biopsy by mediastinoscopy, which showed a non-necrotizing granulomatous lymphadenitis consistent with a sarcoidosis.

Treatment with prednisone and anti-osteoporosis drugs was started and the patient was evaluated at four months with a new chest X-ray. There was a clinical and radiological remission therefore it was decided to gradually reduce the corticosteroid therapy.