Document Detail


Sinonasal involvement in sarcoidosis: a case-control study of 20 patients.
MedLine Citation:
PMID:  17108780     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We conducted a retrospective single-center study to describe the clinical features of sinonasal sarcoidosis (SNS) and to determine whether SNS is associated with a particular clinical phenotype of sarcoidosis. Twenty patients with histologically proven SNS (men/women, 7/13; mean age, 32 +/- 9 yr) were compared with control patients with sarcoid but without sinonasal (SN) involvement. Each patient was matched with 2 controls for the date of admittance in our institution. SN involvement occurred in the course of previously known sarcoidosis in 8 patients, whereas it preceded disease diagnosis in 12 patients. Among these 12 patients, 4 initially presented with strictly isolated SNS and 8 had other associated signs related to sarcoidosis. The most common symptoms were stuffiness (90%), anosmia (70%), and rhinorrhea (70%). Lupus pernio was frequent (50%). Local examination was constantly abnormal and showed hypertrophy (75%) and purplish coloring of the nasal mucosa with granulations (50%) on the septum and/or inferior turbinates. Computed tomography scans showed medial lytic lesions, mainly of the septum and/or the turbinates in about half the cases. All patients had negative antineutrophil cytoplasmic antibodies. Patients with SNS had significantly more frequent and severe involvement of vital organs than controls, had a longer history of sarcoidosis, and required systemic treatment more frequently (100% vs. 57.7%, p < 0.001) and for a longer time (78 +/- 42 mo vs. 29 +/- 18 mo, p < 0.0001). Corticosteroids maintenance dosage was high (10.5 +/- 6 mg daily) and mainly depended on SN involvement. Although rare, SN involvement is a severe and recalcitrant manifestation of sarcoidosis representing a therapeutic challenge.
Authors:
Fleur Cohen Aubart; Michel Ouayoun; Michel Brauner; Patrick Attali; Marianne Kambouchner; Dominique Valeyre; Hilario Nunes
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Medicine     Volume:  85     ISSN:  0025-7974     ISO Abbreviation:  Medicine (Baltimore)     Publication Date:  2006 Nov 
Date Detail:
Created Date:  2006-11-19     Completed Date:  2006-12-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2985248R     Medline TA:  Medicine (Baltimore)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  365-71     Citation Subset:  AIM; IM    
Affiliation:
Universitë Paris 13, UPRES EA 2363, Services de Pneumologie, Höpital Universitaire Avicenne, Assistance Publique-Höpitaux de Paris, Bobigny, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Case-Control Studies
Female
Humans
Male
Paranasal Sinus Diseases / diagnosis,  pathology*,  surgery
Retrospective Studies
Sarcoidosis / diagnosis,  pathology*,  surgery
Tomography, X-Ray Computed

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