Recurrence of sarcoidosis: the follow-up of splenic involvement.
We report the case of a 53-year-old woman who initially presented with an intermittent dry cough that had lasted for 6 months. An investigation into these symptoms with thoracic computed tomography demonstrated hyperdense shadows in her lungs, and ultrasonography showed the presence of multiple hypoechoic nodules on her spleen. A lung biopsy was then performed, which revealed noncaseating epithelioid cell granulomas. Magnetic resonance imagining of her spleen was performed, which showed low signal intensity. The patient was treated with glucocorticoids, and 3 months later the lesions in her lungs had disappeared completely. Five months later, the lesions in her spleen had disappeared also. However, after 13 months of low-dose prednisone, a miliary pattern was observed on the patient's chest x-ray, although no lesions were observed in her spleen. Laboratory tests demonstrated that her blood level of angiotensin-converting enzyme had increased to 96 IU/L. The dose of prednisone was then increased, and the lung images returned to normal after 2 months of therapy.
Department of Neurology, Nanjing General Hospital of Nanjing Military Command, Nanjing, China.
Ying-Ting
YT
Wang
Yi-Ping
YP
Han
Qiang
Q
Li
He-Zhong
HZ
Chen
D001706:Biopsy; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D013902:Radiography, Thoracic; D012008:Recurrence; D012507:Sarcoidosis / Q000175:diagnosis / Q000188:drug therapy*; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology; D013158:Splenic Diseases / Q000175:diagnosis / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed
D005938:Glucocorticoids