Autoimmune hypothyroidism: might its presence be useful to support the diagnosis of sarcoidosis in a patient with acute symmetrical oligoarthritis?

Acute sarcoid arthritis may be present in isolation or as part of Löfgren's syndrome. Its true incidence is unclear since the diagnosis may be difficult when patients present with articular symptoms alone. The diagnosis of sarcoid arthritis is based upon suggestive clinical, imaging, synovial fluid findings, and in some cases upon synovial biopsy. The finding of sterile noncaseating granulomatous inflammation on biopsy is supportive, but it is not pathognomic of sarcoidosis. On the other hand, sarcoidosis has been associated with autoimmune diseases, especially with autoimmune thyroid disease. We believe that it might be of interest to evaluate thyroid function testing in patients with clinical features consistent with sarcoid arthritis, and the diagnosis of sarcoidosis should be considered in patients who present with symmetrical arthritis and thyroid autoimmune disease. We describe herein a patient with subclinical autoimmune hypothyroidism and an acute symmetrical oligoarthritis, with a clinical presentation and laboratory data consistent with acute sarcoid arthritis (Ref. 14).