title: Association of peripheral multifocal choroiditis with sarcoidosis: a study of thirty-seven patients.
abstract: OBJECTIVE
  To assess the clinical spectrum of peripheral multifocal choroiditis (PMC) and its association with sarcoidosis.
  
  
  METHODS
  Thirty-seven patients examined between November 1997 and November 2001 who met all diagnostic criteria for PMC were included in this retrospective study. Patients were assessed for the following signs of sarcoidosis: typical changes on chest radiography or computed tomography; predominantly CD4 lymphocytosis in bronchoalveolar lavage fluid; elevated serum angiotensin-converting enzyme levels; elevated gallium uptake; and noncaseating granuloma on biopsy.
  
  
  RESULTS
  Most of the patients were female (30 of 37; 81%) and white (30 of 37; 81%). Mean +/- SD age at onset was 57.5 +/- 18.7 years. Seven (19%) of the 37 patients had biopsy-proven sarcoidosis and 18 patients (49%) with presumed sarcoidosis met at least 2 of the above-mentioned criteria for sarcoidosis but had normal biopsy results. Twelve patients (32%) had an indeterminate diagnosis. Patients with presumed sarcoidosis did not differ from those with proven sarcoidosis as regards the above-mentioned criteria, except for noncaseating granuloma, implying that more than two-thirds of patients (predominantly whites) had underlying sarcoidosis. Most patients with positive gallium scintigraphy had increased mediastinal uptake, as described in sarcoidosis. Patients with underlying sarcoidosis had more severe visual impairment due to cystoid macular edema (CME). Weekly methotrexate (0.3 mg/kg) seemed to control CME.
  
  
  CONCLUSIONS
  White patients with PMC should be considered to have sarcoidosis. The identification of sarcoidosis in patients with severe ocular disease can help with therapeutic choices.
authors.affiliation: Hôpital Cochin-St. Vincent de Paul, Paris, France. abadsp40@aol.com
authors.forename: S
authors.initials: S
authors.lastname: Abad
authors.forename: V
authors.initials: V
authors.lastname: Meyssonier
authors.forename: J
authors.initials: J
authors.lastname: Allali
authors.forename: H
authors.initials: H
authors.lastname: Gouya
authors.forename: A L
authors.initials: AL
authors.lastname: Giraudet
authors.forename: D
authors.initials: D
authors.lastname: Monnet
authors.forename: C
authors.initials: C
authors.lastname: Parc
authors.forename: F
authors.initials: F
authors.lastname: Tenenbaum
authors.forename: J L
authors.initials: JL
authors.lastname: Alberini
authors.forename: S
authors.initials: S
authors.lastname: Grabar
authors.forename: F
authors.initials: F
authors.lastname: Pesce
authors.forename: F
authors.initials: F
authors.lastname: Rollot
authors.forename: D
authors.initials: D
authors.lastname: Sicard
authors.forename: R
authors.initials: R
authors.lastname: Dhote
authors.forename: P
authors.initials: P
authors.lastname: Blanche
authors.forename: A P
authors.initials: AP
authors.lastname: Brézin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002833:Choroiditis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D005708:Gallium; D006801:Humans; D008269:Macular Edema / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D017565:Sarcoidosis, Pulmonary / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D005708:Gallium; D008727:Methotrexate