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Multisystemic Sarcoidosis in the Primary Care Setting: A Case Report.

Cureus

December 2024

Family Medicine, Unidade de Saúde Familiar (USF) Amato Lusitano, Unidade Local de Saúde (ULS) de Amadora/Sintra, Amadora, PRT.

Sarcoidosis is a rare, multisystemic disease of unknown etiology, characterized by noncaseating granulomas in various organs. The disease often presents with nonspecific symptoms that complicate the diagnosis. We describe the case of a 31-year-old woman who presented to her family doctor with weight loss, cervical lymphadenopathy, parotid edema, and cutaneous lesions, initially raising suspicion of a lymphoproliferative disorder.

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Sarcoidosis is an inflammatory multisystem disease characterised by non-necrotising granulomas that typically affect the lungs, lymph nodes, eyes, skin, liver, spleen, heart, bones and joints. Although rare, necrotising granulomas can also occur. In this report, we present a case of a healthy woman in her 60s who presented with a 1-year history of fatigue and generalised body aches.

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The primary aim of our study was to evaluate the demographic, clinical, and laboratory characteristics of sarcoidosis patients with musculoskeletal symptoms; investigate the relationship between arthritis development and various laboratory parameters (such as vitamin D, liver enzymes, and ACE levels); and compare the sarcoidosis-associated arthritis cases with those without. We also explored the factors influencing arthritis development and the role of biopsy in diagnosing sarcoidosis within rheumatology practice. This retrospective study analyzed 147 sarcoidosis patients from 2000 to 2024, categorized by the presence ( = 45) or absence ( = 102) of arthritis.

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Localized inflammatory reactions in patients with past procedural history of intradermal injections can quickly drive the clinician's attention towards a diagnosis of soft-tissue infection in the context of symptoms such as fever, malaise, and local induration of the adipose panniculus. However, in patients with a long-term history of granulomatous events, a rheumatologic approach must be taken into consideration when the clinical course overwhelms the odds for more conventional diagnoses. In this case, a 39-year-old female patient who underwent bilateral lower limbs intradermal filllers presented with a two-year clinical course of repetitive flares of external bilateral hip tenderness, pain that limits her walking, soft-tissue nodular inflammation, redness, fever and a soft mobile nonpainful right supraclavicular lymphadenopathy.

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Erythema induratum of Bazin (EIB) is a rare manifestation of cutaneous tuberculosis, typically associated with active tuberculosis infections. We present the case of a 75-year-old immunocompetent Spanish woman who developed nodular lesions on her lower limbs. Initial differential diagnoses included sporotrichosis, erythema nodosum, Sweet's syndrome, sarcoidosis, and tuberculosis.

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