Sarcoidosis muscular en una paciente con hipercalcemia no mediada por PTH, reporte de un caso
PDF (Español (España))
HTML (Español (España))

Keywords

Sarcoidosis muscular
reporte de caso
tomografía por emisión de positrones
hipercalcemia
case report
Muscular sarcoidosis
positron emission tomography
hypercalcemia

How to Cite

Rivera Toquica, F., & Arenas Quintero, H. M. (2017). Sarcoidosis muscular en una paciente con hipercalcemia no mediada por PTH, reporte de un caso. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 2(1), 48–53. https://doi.org/10.53853/encr.2.1.72

Abstract

La sarcoidosis es una enfermedad granulomatosa sistémica de etiología desconocida, cuyos síntomas iniciales pueden ser inespecíficos y de intensidad variable, o incluso en muchos casos es asintomática. Cualquier órgano puede estar afectado, sin embargo, se observa con mayor frecuencia compromiso pulmonar y de ganglios linfáticos, seguido por la afectación a nivel oftálmico, cutáneo y hepático, el compromiso muscular aislado es poco frecuente. La sarcoidosis suele ser un diagnóstico de exclusión y en ocasiones puede imitar lesiones malignas, por lo que se debe considerar como un diagnóstico diferencial en muchas patologías, dada la gran variedad de manifestaciones. Presentamos el caso de una mujer de 34 años quien consultó por oligomenorrea, documentándose de manera incidental hipercalcemia no mediada por PTH, finalmente llegando al diagnóstico de una sarcoidosis muscular por medio de los hallazgos en el PET con 18-FDG, lo que permitió la realización de biopsia de músculo glúteo mayor izquierdo para confirmación histopatológica del diagnóstico.

Abstract

Sarcoidosis is a systemic granulomatous disease of unknown etiology, whose initial symptoms may be non-specific and variable in severity, or even asymptomatic in many cases. Any organ can be affected, but the lung and the lymphatic system are mostly involved, followed by the eyes, skin and liver, with isolated muscular involvement being rare. Sarcoidosis is an exclusion diagnosis and, in some cases, it could mimic malignancies, so it should be considered in the differential diagnosis of many conditions, given its diverse manifestations. We present the case of a 34 years old female who complained of oligomenorrhea, with the incidental discovery of a non-PTH-mediated hypercalcemia. Finally, the diagnosis of muscular sarcoidosis was made using 18 FDG-PET followed by histopathology confirmation.

https://doi.org/10.53853/encr.2.1.72
PDF (Español (España))
HTML (Español (España))

References

1. Hutchinson J. Anomalous diseases of skin and fingers: case of livid 3 papillary psoriasis? In: Illustrations of clinical surgery. London: J and A Churchill, 1877:42-3.
2. Rybicki BA, Major M, Popovich J, Jr., Maliarik MJ, Iannuzzi MC. Racial differences in sarcoidosis incidence: a 5-year study in a health maintenance organization. American Journal of Epidemiology. 1997;145(3):234-41.
3. Baughman RP, Teirstein AS, Judson MA, Rossman MD, Yeager H, Jr., Bresnitz EA, et al. Clinical characteristics of patients in a case control study of sarcoidosis. American Journal of Respiratory and Critical Care Medicine. 2001;164(10 Pt 1):1885-9.
4. Rao DA, Dellaripa PF. Extrapulmonary manifestations of sarcoidosis. Rheumatic diseases clinics of North America. 2013;39(2):277-97.
5. Holmes J, Lazarus A. Sarcoidosis: extrathoracic manifestations. Disease-a- month : DM. 2009;55(11):675-92.
6. Haimovic A, Sanchez M, Judson MA, Prystowsky S. Sarcoidosis: a comprehensive review and update for the dermatologist: part I. Cutaneous disease. Journal of the American Academy of Dermatology. 2012;66(5):699.e1-18; quiz 717-8.
7. Siltzbach LE, James DG, Neville E, Turiaf J, Battesti JP, Sharma OP, et al. Course and prognosis of sarcoidosis around the world. The American Journal of Medicine. 1974;57(6):847-52.
8. O’Regan A, Berman JS. Sarcoidosis. Annals of Internal Medicine. 2012;156(9):ITC 5-1
9. Iannuzzi MC, Fontana JR. Sarcoidosis: clinical presentation, immunopathogenesis, and therapeutics. JAMA : the journal of the American Medical Association. 2011;305(4):391-9.
10. Endres DB. Investigation of hypercalcemia. Clinical biochemistry. 2012;45(12):954-63.
11. Rybicki BA, Iannuzzi MC, Frederick MM, Thompson BW, Rossman MD, Bresnitz EA, et al. Familial aggregation of sarcoidosis. A case-control etiologic study of sarcoidosis (ACCESS). American Journal of Respiratory and Critical Care Medicine. 2001;164(11):2085-91.
12. Dempsey OJ, Paterson EW, Kerr KM, Denison AR. Sarcoidosis. BMJ (Clinical research ed). 2009;339:b3206.
13. Heinle R, Chang C. Diagnostic criteria for sarcoidosis. Autoimmunity Reviews. 2014;13(4-5):383-7.
14. Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. The New England Journal of Medicine. 2007;357(21):2153-65.
15. Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Muller-Quernheim J. Sarcoidosis. Lancet. 2014;383(9923):1155-67.
16. Spagnolo P, Luppi F, Roversi P, Cerri S, Fabbri LM, Richeldi L. Sarcoidosis: challenging diagnostic aspects of an old disease. The American Journal of Medicine. 2012;125(2):118-25.
17. Silverstein A, Siltzbach LE. Muscle involvement in sarcoidosis. Asymptomatic, myositis, and myopathy. Archives of Neurology. 1969;21(3):235-41.
18. Vardhanabhuti V, Venkatanarasimha N, Bhatnagar G, Maviki M, Iyengar S, Adams WM, et al. Extra-pulmonary manifestations of sarcoidosis. Clinical Radiology. 2012;67(3):263-76.
19. Eklund A, du Bois RM. Approaches to the treatment of some of the troublesome manifestations of sarcoidosis. Journal of Internal Medicine. 2014;275(4):335-49.
20. Chang WT, Radin B, McCurdy MT. Calcium, magnesium, and phosphate abnormalities in the emergency department. Emergency Medicine Clinics of North America. 2014;32(2):349-66.
21. Civitelli R, Ziambaras K. Calcium and phosphate homeostasis: concerted interplay of new regulators. Journal of Endocrinological Investigation. 2011;34(7 Suppl):3-7.
22. Braun J,Kessler R, Constantinesco A, Imperiale A. 18F-FDG PET/CT in sarcoidosis management: review and report of 20 cases. Eur J Nucl Med Mol Imaging. 2008 Aug;35(8):1537-43.
23. Treglia G, Taralli S, Giordano A. Emerging role of whole-body 18F-fluorodeoxyglucose positron emission tomography as a marker of disease activity in patients with sarcoidosis: a systematic review. Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG / World Association of Sarcoidosis and Other Granulomatous Disorders. 2011;28(2):87-94.

Authors must state that they reviewed, validated and approved the manuscript's publication.  Moreover, they must sign a model release that should be sent.  A copy may be reviewed here

Dimensions


PlumX


Downloads

Download data is not yet available.