[Splenomegaly in sarcoidosis: clinical features and outcome. Analysis of 17 cases].
OBJECTIVE
To describe the clinical features, biological datas and outcome of patients with systemic sarcoidosis and splenomegaly.


METHODS
A retrospective analysis of 17 patients presenting splenomegaly and sarcoidosis with histological proof.


RESULTS
Splenomegaly was clinically perceptible in 13 patients, with a spleen size that extended 4 cm or more below the costal margin in 11 patients. It was painful in five cases. The more frequent clinical features are constitutional symptom (fever in 9 cases) and hepatomegaly (N =7). Chest X-ray showed bilateral hilar lymphadenopathy in nine patients and no abnormality in five cases. Serum angiotensin converting enzyme levels were elevated in 81% of cases. Thrombopenia (N =5) and hypersplenism (N =5) were also observed. Corticosteroid were given to 88% with a good clinical and biological response including a decrease in the spleen volume. Corticotherapy and splenectomy (performed in two patients to rule out lymphoma) didn't change outcome of disease. Sarcoidosis is often chronical (82%) and extensive.


CONCLUSIONS
Splenomegaly may be present in sarcoidosis. Management is not standardized. Corticosteroid is indicated for symptomatic or massive splenomegaly. Splenomegaly is frequently in chronic and extensive sarcoidosis.
Madaule
S
S
Service de médecine interne, pavillon des médecines, CHU Purpan, place Baylac, 31059 Toulouse cedex, France. madaule.s@chu-toulouse.fr
Lauque
D
D
Sailler
L
L
Arlet
P
P
Carles
P
P
D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D005334:Fever / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000150:complications*; D013156:Splenectomy; D013163:Splenomegaly / Q000188:drug therapy* / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones