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Sarcoidosis Vasc Diffuse Lung Dis. 2019;36(1):60-63. Epub 2019 Mar 11.

Musculoskeletal and pulmonary outcomes of sarcoidosis after initial presentation of osseous involvement.

Author information

1
Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston MA.
2
Division of Pulmonology, University of Michigan, Ann Arbor, MI.
3
Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.

Abstract

Objective:

We aimed to investigate the musculoskeletal and pulmonary outcomes of patients with osseous sarcoidosis.

Methods:

We identified 24 patients with osseous sarcoidosis and at least one year of follow-up after diagnosis (baseline). We collected outcome data at 1-year follow-up and last follow-up. We defined a composite outcome measure; worsening considered as worsening in any of the following 4 components compared to baseline: 1) osseous sarcoidosis symptoms, 2) musculoskeletal imaging of affected bone, 3) chest imaging, or 4) pulmonary function testing (PFT).

Results:

A minority of patients had a worsening composite outcome at 1-year (9/24, 38%) and last follow-up (5/24, 21%). When only considering musculoskeletal symptoms and imaging, only 25% (6/24) and 13% (3/24) of patients worsened compared to baseline at 1-year and last follow-up, respectively. Patients with a worsening composite overall outcome tended to be older at baseline than those without the outcome for both 1-year (54.3 years vs. 47.5 years, p=0.11) and last follow-up (55.0 years vs. 48.7 years; p=0.23), although these differences were non-significant. Treatment was not associated with worsening composite overall outcome at 1-year follow-up (p=0.40), but was significantly associated with decreased risk for worsening at last follow-up (p=0.05).

Conclusions:

In this retrospective cohort study of osseous sarcoidosis, most patients had a favorable outcome according to symptoms, musculoskeletal/chest imaging, and PFTs, even though only a minority were treated with glucocorticoids or DMARDs. These results suggest that the natural history of osseous sarcoidosis is often benign, although some patients experience clinical progression.

KEYWORDS:

Autoimmune Disease; Bone Tissue; Health Outcomes; Pulmonary Disease; Pulmonary Function Test; Sarcoidosis

PMID:
30918438
PMCID:
PMC6433168
[Indexed for MEDLINE]
Free PMC Article

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